Since there is so much misinformation still flying around since yesterday, I felt it was important to clarify a couple of things: the Supreme Court ruled yesterday (and I do NOT agree with their ruling, by the way) that closely-held companies could (even though that mechanism is not in place yet) apply for the cost-covered Religious Exemption.
Well I looked up the 'existing ACA rules' and it still requires insurers and third-part administrators to provide contraceptive coverage at no cost to the insured. That is the existing provision for non-profits, which Alito's opinion suggests as the 'least restrictive' method for meeting the ACA mandate. Quotes and links below the fold.
What happened yesterday?
The SCOTUS expanded the category of employers eligible for the religious exemption for coverage of contraception services. I am sort of amazed that everyone seems to be misunderstanding and thinking 'women won't get coverage.' According to the HHS, and I am pasting from their page, here is the current law as it applies to both religious employers with health plans and religious employers who self-insure:
"The final rules also lay out the accommodation for other non-profit religious organizations - such as non-profit religious hospitals and institutions of higher education - that object to contraceptive coverage. Under the accommodation these organizations will not have to contract, arrange, pay for or refer contraceptive coverage to which they object on religious grounds, but such coverage is separately provided to women enrolled in their health plans at no cost. The approach taken in the final rules is similar to, but simpler than, that taken in the proposed rules, and responds to comments made by many stakeholders.
With respect to an insured health plan, including a student health plan, the non-profit religious organization provides notice to its insurer that it objects to contraception coverage. The insurer then notifies enrollees in the health plan that it is providing them separate no-cost payments for contraceptive services for as long as they remain enrolled in the health plan.
Similarly, with respect to self-insured health plans, the non-profit religious organization provides notice to its third party administrator that objects to contraception coverage. The third party administrator then notifies enrollees in the health plans that it is providing or arranging separate no-cost payments for contraceptive services for them for as long as they remain enrolled in the health plan."
(Bold was added by me)
Reference: Department of Health and Human Services
So what does this mean? It means that the employees of Hobby Lobby will still get contraceptive coverage: but that HL won't have to contribute to it. The cost will be absorbed by the insurer and they can make up this cost in their premium structure for the entire plan.
So why is nobody getting this?
For self-insurers (see the last paragraph above) they can recover the costs through the ACA exchange user fees in their contract with the Exchanges:
"The costs of such payments can be offset by adjustments in Federally-facilitated Exchange user fees paid by a health insurance issuer with which the third party administration has an arrangement."
Reference: Center for Medicare and Medicaid Services
http://www.cms.gov/...
So - what happened yesterday is that the Supreme Court added "and closely held corporations with a 'sincerely held religious belief' to the "non profit religious institutions" categorization. The method and means of providing contraceptive coverage did not change by expanding this class.
Ultimately what this REALLY means is that insurance companies just got handed a big bill when they insure employees of religious closely-held corporations. And it will likely drive up premiums. So yes, it is a kick in the pants to the ACA, but it is not a denial of services for women.
UPDATE: Following discussion in the diary, even though Alito's opinion (see discussion below) suggests a 'less restrictive means' of providing women's health coverage through the existing mechanism of the Religious exemption (which is required to be paid for by insurance companies) it did not direct the government to do so. I have updated the diary title to reflect this. And many thanks, Adam B.