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San Francisco�Even if they say that doing so violates the basic tenets of their religion, employers must provide coverage for contraception as part of employee health care plans, the California Supreme Court has ruled. The court said that even church-affiliated employers must qualify as a “religious employer” in order to be exempt from a state law that requires contraceptive coverage by employers who also provide insurance for prescription drugs. Catholic Charities of Sacramento Inc. v. Super. Ct. (Dep’t of Managed Health Care), No. 04 C.D.O.S. 1737. The 6-1 decision upholds the constitutionality of the California Women’s Contraception Equality Act, passed by legislators in 1999 to eliminate gender discrimination. Studies had shown that women in their childbearing years spend at least 68% more than men on out-of-pocket health care costs, largely because of contraceptive prices and unintended pregnancies. “This is a huge victory for working women in California,” Attorney General Bill Lockyer, whose office defended the state, said in a prepared statement on March 1. “California courts have consistently ruled that non-religious employers cannot use religion to discriminate against women in the workplace,” he said. “[This] ruling upholds the principle that all people, including women, must be treated as equals.” ‘Outrageous affront’ But the American Life League’s Crusade for the Defense of Our Catholic Church called the ruling “an outrageous affront” to all people of faith. “It seems that the state of California is intent on convincing the world that up is down, that wrong is right,” the Virginia-based group’s director, Joseph Starrs, said in a prepared statement. “It seeks to recognize rights where they don’t exist, while usurping the constitutional right of Catholic Californians to the free exercise of religion.” Catholic Charities of Sacramento Inc., a nonprofit corporation that provides health and social services for the poor, disabled and elderly, had challenged the state law, saying it conflicted with church teachings that contraception is a sin. The corporation, whose 183 employees’ health coverage is provided by Blue Shield of California and Kaiser Permanente, said forced contraceptive coverage violates the establishment clause and the California Constitution’s religious freedom clause. The agency claimed it qualified as a “religious employer,” exempting it from the contraception equality act’s requirements. However, Justice Kathryn Mickle Werdegar, who wrote the majority ruling, held that Catholic Charities didn’t meet the criteria laid out for an exemption under the contraception equality act. “Catholic Charities concedes,” she wrote, “that its purpose is not the inculcation of religious values, that it does not primarily hire and serve Catholics and that it does not fall within either of the relevant provisions of the Internal Revenue Code” to qualify as a nonprofit. Werdegar also dismissed Catholic Charities’ contention that its compliance with a law on health care benefits implicated free speech issues. “The law leaves Catholic Charities free to express its disapproval of prescription contraceptives and to encourage its employees not to use them,” she wrote. In dissent, Justice Janice Rogers Brown argued that the law in question was “an intentional, purposeful intrusion” by the state into an organization’s religious tenets and “sense of mission. “The government is not accidentally or incidentally interfering with religious practice,” she wrote. “It is doing so willfully by making a judgment about what is or is not religious. This is precisely the sort of behavior that has been condemned in every other context.” Brown also scoffed at the criteria set forth concerning exemptions for religious employers. She called them narrow. “This is such a crabbed and constricted view of religion that it would define the ministry of Jesus Christ as a secular activity,” she wrote. “The stinginess of the exemption makes the structure of the act all the more baffling.” Brown also said that women of childbearing age to whom contraceptive coverage is a major concern are not prevented from finding “more congenial employment.”

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