Supreme Court Faces Decision on Case That Could Change Health Care Coverage

The Supreme Court could decide on a case that would potentially alter health care coverage for abortion across the country.

The Roman Catholic Diocese of Albany, New York, is appealing to the highest court after an appellate court ruled that religious charities must follow state law and provide employee coverage for abortions.

The Roman Catholic Diocese of Albany, New York, is preparing to file a petition for certiorari to the Supreme Court. If the Court accepts the case, the justices would be ruling on whether religious organizations have a right to deny coverage for services they find contrary to their religious beliefs. The diocese has until September 18 to file for review from the Court.

The case, Roman Catholic Diocese of Albany v. Harris, concerns the rules that are outlined by Adrienne Harris, the superintendent of the New York Department of Financial Services. The department requires all employers to offer insurance coverage for abortions as of 2017.

The only exception was for religious organizations whose “purpose” is to instill religious values and who employ and “serve” people of the same religion. However, religious entities that have a broader mission or employ people outside of the religion were still mandated to offer the abortion coverage.

“This case is a pivotal case between law and religious belief,” Chris Fong, a Medicare specialist and the CEO of Smile Insurance Group, told Newsweek. “The regulation requirement for abortion services coverage by employer health insurance is limited in its religious exception. The church is caught between the choice of pursuing the purpose of offering and supporting anyone who is in need regardless of denomination or faith or abiding by a foundational belief.”

In 2020, the Appellate Division of the Supreme Court of New York ruled in the state’s favor. However, the U.S. Supreme Court said the case needed to be revisited once again in 2021 after the Fulton v. Philadelphia ruling was issued.

In that case, the U.S. Supreme Court decided that Roman Catholic charities could deny placing foster children with same-sex couples based on their First Amendment religious freedom rights.

In June 2022, the second appeal case for Roman Catholic Diocese of Albany v. Harris found that the Fulton ruling did not apply here, and First Amendment rights did not allow religious organizations to refuse health insurance coverage of abortion.

However, when the Appellate Division of the Supreme Court of New York reconsidered the case in June 2022, it ruled in favor of the state, finding that Fulton did not apply to the case and that the abortion insurance mandate did not violate the First Amendment.

Once again, in May of this year, the New York Court of Appeals ruled in the state’s favor.

“Under Fulton, both the regulation itself and the criteria delineating a ‘religious employer’ for the purposes of the exemption are generally applicable and do not violate the Free Exercise Clause,” the court wrote.

“While many may feel the overturning of Roe v. Wade was a comprehensive decision, it actually left many questions to how abortions are funded at a state level open-ended,” Alex Beene, a financial literacy instructor at the University of Tennessee at Martin, told Newsweek.

In the summer of 2022, the Supreme Court released a ruling that overturned Roe—the nearly 50-year-old decision that protected a pregnant woman’s constitutional right to choose to have an abortion.

In the past, the Supreme Court has generally ruled in favor of employers concerning health insurance coverage of birth control or medications for abortion.

The implications of this case reaching the Supreme Court are wide reaching.

If more churches decide to follow their “foundational beliefs” and work around the New York rule by closing their services to just those within their religion, there could be a significant loss of social services, Fong said. That includes homeless shelters, food pantries and various counseling and support services.

“Alternatively, if they decide to continue to serve the public through these programs, they are going against the very nature of their religion,” Fong added. “I do think that most people employed by these organizations would also follow the same belief system and would not have a true effect on the people employed by the churches.”

The Supreme Court would still have to choose to take the case instead of honoring the earlier appeals decision, but Fong believes it’s likely considering the Court already sent the case back for reconsideration based on the Fulton ruling.

“Past decisions by this court do indicate how they could rule on the case, with most feeling they’re going to take the side of religious freedom over state fiscal policy,” Beene said. “At the same time, financially complex cases aren’t always as clear-cut, and the Supreme Court may conclude a state is within its rights to set insurance requirements even if past decisions have clearly carried pro-life opinions.”