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Supremes launch attacks on women's health care 

This is not good.

As it wrapped up its term last month, the Supreme Court issued decisions – twice – that were aimed squarely at women and women's health and reproductive rights.

On June 26, they weakened a Massachusetts law and opened the door for anti-abortion activists to give advice, close and personal, to women entering reproductive-health facilities in that state.

And on June 30, they sided with closely held corporations who want to deny health insurance coverage for contraception.

Both decisions are troubling. And it seems likely that similar, perhaps broader, rulings lie ahead.

In the June 26 decision, McCullen v. Coakley, the court said a Massachusetts law dealing with protests at reproductive health facilities is unconstitutional. Under that law, anti-abortion activists could protest, but they had to stay 35 feet away from the facilities' entrance. That restriction, said Eleanor McCullen, who brought the suit, limits her ability to talk directly to women heading into the facility.

The court's decision was unanimous; surprisingly (to me), the three women justices – among the Court's most liberal members – went along.

Many analysts have noted that the McCullen ruling was narrow, applying only to the Massachusetts law, which has strict limits on protests. New York's buffer zone is only 15 feet – and significantly, protesters can demonstrate within that zone. They just can't block or obstruct the entrance to the facility, "follow and harass" people, or indulge in similar aggressive behavior.

Balancing women's privacy rights and protesters' free-speech rights isn't easy. But I don't see how requiring protesters to keep a respectful distance is a serious restriction on their right to speak.

Abortion is a legal, and quite serious, medical procedure. Women and their families have a right to enter a health-care facility without being lectured, preached at, intimidated, and humiliated.

Unintended or not, there's a good bit of arrogance in deciding that a woman entering a medical facility needs advice that she hasn't gotten from her doctor. As with many things related to this issue, anti-abortion protesters seem to think that women undergo an abortion without thinking it through – and without understanding the seriousness of the procedure.

And the McCullen decision may be just the beginning. Three justices – Antonin Scalia, Anthony Kennedy, and Clarence Thomas – were clear, in fact, about how they feel about buffer zones, saying that they favored overturning a previous Supreme Court ruling that supported a narrower buffer zone.

And here's what an attorney for the conservative Christian group Alliance Defending Freedom told Politico: "This may end up meaning the end of most abortion clinic zones around the country, because I think most states and localities are not going to be able to show that they truly have a compelling interest."

Distance limits on protests are common. In New York State, you can't pass out campaign literature or otherwise promote a political candidate within 100 feet of the entrance to a polling place. Protests are routinely restricted around political conventions. Protests are prohibited from a large area in front of the Supreme Court building itself.

But women entering a medical facility, some of them already under emotional stress – and many of them there for health care unrelated to abortion – must submit to personal confrontation, protests, and preaching.

In the second case, Burwell v. Hobby Lobby, the court ruled 5-4 that insurance policies of closely held companies don't have to cover contraception if the company owners maintain that it violates their religious beliefs.

News reports after the decision estimated that closely held corporations – some of them, like Dell, quite large – employ 52 percent of US workers. It's impossible to know how many owners of closely held companies will take advantage of the ruling, or how many people will be affected. There will be some, though, starting with the employees of Hobby Lobby and Conestoga Wood Specialties, which brought the suit.

Just as serious is what this ruling points toward. As with McCullen, the Hobby Lobby decision was a narrow one, affecting only closely held corporations. But the federal health care law already provides exemptions for churches as well as schools, universities, and hospitals that are operated by religious organizations. That's a lot of employees.

And this won't be the end. People and organizations opposed to contraception in any form – and critics of the Affordable Care Act, which requires contraception coverage – know a friendly court when they see one.

The justices in the majority suggested that there's a way around this tricky business of balancing religious freedom and women's health needs: just have the government pay for contraceptive coverage for everybody.

Yes! Single-payer health care!

Not from this Congress or any one in the foreseeable future.

I don't know whether to laugh or cry.

And as several commentators have suggested, contraception may not be the only area of health care that runs into a religious-freedom suit. Some Americans have strong religious objections to vaccinations. If we exempt employers from providing coverage for contraception when that violates their religious beliefs, by what stretch of logic could we require employers to cover vaccinations?

And Brookings Institution Senior Fellow Jonathan Rausch expands on that concern, suggesting that "it's now inevitable" that owners of some closely held businesses will sue over having to provide health benefits for same-sex couples. "I think gay marriage is going to come up very fast," he said in a Brookings blog interview.

A few optimists are hoping that the Hobby Lobby decision will help Democrats running in this year's mid-term Congressional election.

A Politico report included this statement from Dawn Laguens, executive vice president of the Planned Parenthood Action Fund: "The idea of giving bosses a right to discriminate and deny employees access to birth control is deeply unpopular and will be a rallying call for women and families across the country headed into the elections this November."

Well, I hope so. I hope so. But these rulings are just as likely to encourage an already fired up conservative base.

I'm not seeing much of a silver lining.

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