The HHS contraceptives mandate requires all employer health plans (unless they have retained their grandfathered status) to cover all FDA-approved contraceptive services, including IUDs and emergency contraceptives that act as abortifacients. Churches are exempt. Businesses are not, no matter the convictions of the owners and the mission of the business (except that the courts are strongly favoring businesses that have challenged the mandate). Religious nonprofits, such as faith-based hospitals, schools, colleges, and charities, have an “accommodation”: they can buy insurance that excludes some or all of the required contraceptive services, and then the insurer or their third-party administrator has to tell the employees that it will pay for the excluded items anyway (again, the courts are strongly favoring the nonprofits that object).

Outside of court action, what can a faith-based service organization with a religious objection to the mandate do? It can drop insurance coverage, although such action may also violate its religious convictions about how to treat its employees. It can drop coverage, increase salaries, and encourage its employees to join a health care sharing plan (see the Alliance of Health Care Sharing Ministries), although there is no guarantee they will all be accepted into a program in which the Christian members share each other’s (health care cost) “burden.”

If the organization is Southern Baptist, it might explore whether it can join Guidestone, an insurance company that has won an injunction against the federal government so that its health insurance plans do not have to cover abortifacients.

And if the organization is Catholic, it can now explore membership in the Catholic Benefits Association (CBA), a new group that manages self-insurance plans and is seeking an injunction so that it can exclude from those plans contraceptives and abortifacients. The CBA also helps its members understand the increasingly morally-fraught world of health insurance and health insurance regulation.