I thought Burwell v. Hobby Lobby was about something, but according to the Cato Institute I was wrong:
The Department of Health and Human Services has already developed a way to exempt religious non-profit corporations—such as churches, charities, and hospitals—from the legal mandate to pay for employees’ contraception coverage. In what amounts to an accounting trick, they permit those corporations to purchase plans without such coverage, and then require that insurance companies themselves independently provide it to the uncovered employees. Because pregnancy is quite a bit more expensive than contraception, this apparently ends up not imposing any additional net cost on the insurers. The result is that employees of religious non-profits end up with no-copay contraception coverage, exactly as if the employer were required to provide it directly, but the employers are satisfied by this ledger shuffling that they aren’t being compelled to violate their most deeply held moral convictions. Which, one would think, is a win-win.
Against this background, the Court simply held that […] they must do the same in the case of for-profit employers, at least where the for-profit corporation is “closely held.” The majority quite explicitly denied this ruling has any implications for cases where there might not be such a happy win-win means of achieving the government’s ends, at no additional cost, without forcing employers to violate their convictions.
So: employers are allowed to purchase a plan that explicitly does not cover certain things, but only if the insurance company providing the plan explicitly covers those things. As the Cato institute notes, this is merely ledger shuffling. And if it makes Hobby Lobby feel better to shuffle its ledger this way, why not allow it? In fact, why not allow any employer to do so? The net impact on employees is zero.
According to this, the Little Sisters of the Poor aren’t satisfied with ledger shuffling. To shuffle the ledger, they would have to fill out a particular form (ESBA Form 700) stating their objection to providing contraceptive coverage—which would trigger such coverage from their insurer. They are refusing to fill it out, and the net impact on employees is positive, i.e certain contraceptives are not provided.