The case of Sebelius v. Hobby Lobby, which was presented to the Supreme Court on March 25, involves the unprecedented, highly controversial issue of a for-profit company’s claim to “religious liberty” because it opposes paying for certain types of birth control for employees as mandated by the Affordable Care Act.
At the very least, this case seeks to strike the mandate for free preventive coverage of all types of birth control from the ACA. At most, its ultimate goal is to totally destroy the ACA.
To understand why this mandate is in the law, it’s important to understand why contraception matters to women and their families and why workers shouldn’t have to pay for it.
The Centers for Disease Control and Prevention has hailed family planning as one of the 10 great public health achievements of the 20th century, alongside vaccinations and control of infectious diseases. In scientific research used to formulate the ACA, many health care professional organizations recommended that birth control be provided as preventive care. That is what prompted the Institute of Medicine to include contraception in the list of women’s preventive services that must be included in the law. By definition, a preventive service must be provided free of charge.
Mandate benefits poor working women
In an article posted March 25 on RH Reality Check, Dr. Tania Basu, an obstetrician-gynecologist, outlined the top reasons why contraceptive coverage is essential. Not only does it save lives, provide many ob-gyn health benefits, and build healthy families and communities, but it also allows a woman to choose the method that is right for her and not one that fits her budget.
Dr. Basu cited the Contraceptive CHOICE Project, a study conducted with 10,000 women in the St. Louis area from 2007 to 2011, to see what would happen if cost was eliminated. Without financial barriers, 75 percent of the women “chose a long-acting, highly effective method (an IUD [intrauterine device] or contraceptive implant), which typically has a high up-front cost of hundreds of dollars.”
Statistics based on research compiled by the Guttmacher Institute corroborate that. In its friend-of-the-court brief submitted Jan. 31, Guttmacher noted that insurance coverage is shown to improve use, especially when cost is eliminated, and that the most highly effective methods, such as IUDs, implants and sterilization, are the most costly.
“Even for the pill, uninsured women on average pay $370 for a full year’s supply; this is the equivalent of 51 hours of work for someone making the federal minimum wage of $7.25. So it is no surprise that one-third of women would switch methods if they did not have to worry about cost. Removing cost barriers … has been proven to make a substantial difference in facilitating access to and use of needed care.”
A survey about contraceptive use conducted by Planned Parenthood in anticipation of the ACA found that “one in three women voters (34 percent) have struggled with the cost of prescription birth control at some point in their lives. For young adult women, who are most likely to experience an unintended pregnancy, more than half (55 percent) experienced a time when they could not afford to use birth control consistently.” The survey also showed that 71 percent of voters “believe insurers should be required to fully cover” all “forms of prescription contraception” under the ACA. (March 12, 2010)
Obviously, those who stand to gain the most from the contraception mandate are poor working women — the 70 percent of women who work for poverty wages in the retail, restaurant, farming and banking industries, among others — and the families of other low-wage workers. But all women workers who, on average, make 77 cents for every dollar a man makes, stand to gain, especially African-American, Latina and Native women who make even less.
Health care coverage is currently provided by employers of 55 percent of the workforce. What many workers may not be aware of is that health care coverage is a benefit that workers earn. It is paid for out of workers’ earnings that the bosses withhold. If the Supreme Court ruling, due in June, eliminates the contraception mandate from the law, then this is another reason why all workers should be fully compensated for their unpaid labor.
Corporations are looking for ways to lower costs and boost profits in this era of dead-end capitalism. Desperately grasping at straws like opposing the contraception mandate appeals to them.
Part 3 will dissect the 71 other companies that have sued to be excluded from the contraception mandate, the far-right institutions that financially back them, and Hobby Lobby’s hypocrisy.
Sue Davis is a longtime activist for women’s rights, equality and reproductive justice.