Religious liberty challenges to the Affordable Care Act often appear narrowly focused on exempting specific employers from covering particular types of care, such as contraceptives, sterilization, or gender-affirming care. However, closer examination reveals that such claims should be understood as a major new vector in the campaign against social insurance in the United States.

Next week, the Supreme Court will hear arguments in a case that may allow some employees to foist the cost of their religious exercise onto their co-workers. Such an outcome, beyond its obvious unfairness, threatens to reduce collective labor power. Workplaces and unions rely on a sense of reciprocity, mutual support, and solidarity. But if employers are required to inflict the burdens of one religious worker’s accommodation on their fellow employees, workers may come to see themselves as competitors, rather than allies. By pitting workers against each other, the Court threatens to dissolve workplace solidarity and sabotage workers' ability to act collectively.

An alliance between religious and economic conservatives is playing a central yet overlooked role in the resurgence of concentrated economic power in America, resulting in the transfer of public funds, services, and decision-making away from more democratic institutions. Nowhere is this more evident than in the rise of "government-religious hospitals": these hospitals are state owned, yet religion permeates their halls, and faith dictates the care they offer. To mitigate the risk that these arrangements pose, we must make innovative use of LPE’s tools, including antitrust, public utility regulation, and public options.