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Supreme Court rules against Obamacare's birth control mandate

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Mark Wilson

The Supreme Court narrowed Obamacare's requirement that all employer-sponsored health insurance cover birth control, ruling that "closely-held corporations" did not have to comply with the regulation.

In Burwell v. Hobby Lobby, the court ruled 5-4 that it will allow some business owners to exclude birth control from their insurance plans if coverage would violate their religious beliefs.

The decision, authored by Justice Samuel Alito, found that "closely-held corporations" — defined by the Internal Revenue Service as those where five or fewer individuals own a majority of the company's stock — do not have to include birth control in the health insurance package they offer workers.

The decision doesn't undercut Affordable Care Act's larger insurance expansion, as repealing the individual mandate - an issue the Supreme Court weighed in 2012 - would have. But a ruling against the mandate could be a blow to women's health advocates, who have vigorously defended the provision as crucial to women's health. It could also have wide-reaching consequences for the religious liberties of corporations.

The birth control mandate is one of eight women's preventive health benefits that Obamacare requires health plans to provide without any cost to the patient. Other required benefits include breastfeeding equipment, HPV testing and domestic violence screenings.

Obamacare directed the Institute of Medicine, an independent, congressionally chartered body, to define what medical services should be included as women's preventive health benefits. The health care law did not include a specific list of services.

The IOM's decision to include birth control as a preventive benefit set off a fierce political fight, with religious business owners, hospitals and universities protesting the requirement to cover particular types of contraceptives, particularly intra-uterine devices and emergency contraceptives.

While the White House gave some relief to religiously-affiliated hospitals and universities, the Obama administration has argued that private business owners must comply with the mandate.

More than 40 private businesses filed lawsuits against the contraceptive mandate, mostly arguing that the new requirement was a violation of religious liberties. The case the Supreme Court heard was brought by Hobby Lobby, the large craft-store chain, whose owners argued that providing contraceptives to their employees violated their Pentecostal religion.

LIVE Q&A

From 2 p.m. to 3 p.m. ET, Sarah will answer your questions here about the Hobby Lobby ruling and what it means for Obamacare and women's access to birth control.