The Trump administration's decision to expand employers’ rights to deny insurance coverage for contraception may invite the culture wars into doctors’ offices, Professor Robert Field wrote in an op-ed essay published by the Philadelphia Inquirer on Oct. 12.

Exceptions to Affordable Care Act recently announced rules for preventive care apply only to contraception covered through insurance arranged by an employer, Field said.

“The exemptions inject your employer’s values into the business of health insurance. They let the organization you work for shape your coverage according to values that have nothing to do with medical necessity or clinical judgment. And they pay no regard to whether you or your physician shares those values,” Field said. “This is new ground for the health-care system.”

The new rules could interfere with decision that should be based solely on “medical necessity,” Field said.

What’s more, Field added, the change raises “fundamental concerns” in part by allowing for-profit and nonprofit employers alike to claim that “moral qualms” prevent them from covering contraceptive care for employees.

“How, exactly, does a for-profit corporation adopt a religious belief? It is a business entity with a primary obligation to make money for its shareholders,” Field said. “If it were to adopt a religion, who would decide which one to choose — management, employees, shareholders? They all play essential roles. Religious beliefs are personal, not the province of a profit-making machine composed of multiple constituencies and interests.”

By exclusively limiting contraceptive coverage, Field noted, the new rules also neglect to acknowledge diverse medical practices like vaccinations and blood transfusions that are objectionable to some religious traditions.

“America has always shown great deference to religion, and properly so,” he wrote. “That deference should respect the religious and moral beliefs of patients, as advised by their physicians, not those of businesses whose primary mission is to generate profits. And if deference means special exemptions from legal requirements, the government must grant them or deny them for all religious and moral beliefs equally, without favor for those it decides are worthy.”