The Supreme Court ruled against imposing the contraceptive mandate on for profit religious companies in part because there's a less religiously "burdensome" alternative in place for non-profits: the insurer foot the bill and the government reimburses them. The justices suggested that President Obama should just make that accommodation available to the Hobby Lobbys of the world. Unfortunately, that accommodation only works smoothly on paper.
According to Bloomberg's Alex Wayne, under the current system the administrator of a religious non-profit's health plan pays for objectionable forms of birth controls, and the government reimburses them. The third-party administrators say the government doesn't have a way to pay them back yet.
Here's how it should work: the third-party administrator would either find an insurer to cover the cost of the birth control, or pay for it themselves and find a partner insurer through the exchange. Then, the government reimburses the insurer and, if necessary, the insurer reimburses the administrator. But administrators who aren't tied to insurance companies haven't been able to get insurers to agree to that deal and the Department of Health and Human Services says they don't have the legal authority to pay the administrators directly.
The problem doesn't affect all administrators, but there are 300 of them across the country looking at paying millions of dollars. As we explained earlier this week, the Supreme Court heavily implied that Obama should make that same accommodation available to for profits. Mike Ferguson, the chief executive officer of a trade group that represents insurance administrators, told Bloomberg he's worried that would only make things worse for them. "If that is the accommodation the administration chooses, then it would create the same problems, in our view, that are currently in play for the nonprofit religious organizations," he said.
That is still an "if." Even though the Supreme Court pushed the president towards an executive action, he's said that "Congress should act to address the concerns of the women who are affected by this decision." Given how productive Congress has been, it's possible that this will get dragged out as long as possible for political purposes. That's great news for third-party administrators, but not for women.