You are the chief nursing executive for a small rural clinic that provides contraception services to low-income individuals. An insurer, providing care under the ACA, has rejected paying the claims, stating that they are a not-for-profit religious organization and are not obliged to cover these services.

You check your records and find that nonpayment for contraception places a significant financial burden on the clinic. These individuals do not have access to any other healthcare services in the region.

a. What ethical dilemmas do you identify in this scenario?

b. What legal issues do you identify in this scenario?

c. What action do you recommend?

d. How do you justify this action based on legal and ethical guidelines?