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Tag: contraceptive mandate
The Contraceptive Mandate Finally Leads America Out Of The Victorian Era

The Contraceptive Mandate Finally Leads America Out Of The Victorian Era

The Affordable Care Act demonstrates an affirmative, proactive step from government for women’s access to reproductive health care, but conservatives are bent on moving backwards.

Contraception should be understood as a fundamental right of American women and a necessary foundation of human security. If that seems controversial, consider this: 99 percent of American women approve of birth control and the vast majority use it over many years of their lives. These women deserve and must continue to demand insurance coverage for the method of their choice, without qualification. That’s why the contraceptive mandate in the Affordable Care Act (ACA) is so important and potentially transformative. For the first time ever, all health insurance plans, whether paid for privately or with public subsidies, are required to cover all FDA-approved contraceptives at no additional cost.

Family planning is essential to securing the health and rights of women, but it is also the foundation of sound economic and social policy. Tragically, however, U.S. subsidized family planning programs currently serve just over half of those in need.

The stakes are especially high for poor women, who cannot afford the high costs of the most reliable and desirable methods and experience much higher rates of early and unwanted pregnancy as a result. Single women in poverty head a growing percentage of U.S. households. In “Breaking the Cycle of Poverty: Expanding Access to Family Planning,” a new white paper released today by the Roosevelt Institute, we argue that addressing their needs, and opening up opportunities to them and their children, will require multiple policy interventions, but none can work if women are denied the right and the agency to make, and act on, well-informed decisions about their own bodies.

Decades of social science research demonstrate that access to reliable and affordable family planning methods promotes responsible decision making and reduces unwanted pregnancy and abortion. It allows women to pursue educational and employment opportunities that strengthen their families and their communities. A majority of women who participated in a recent study by the Guttmacher Institute, for example, report that birth control enables them to support themselves financially, complete their education, and get or keep a job. Other recent studies also show that providing family planning services at no cost results in more effective contraceptive use, decreased rates of unintended pregnancy, and dramatic declines in abortion rates.

Many American conservatives, however, reject these claims. They blame single mothers for America’s rising tide of poverty and inequality, not the other way around. They insist that access to sexual and reproductive health information and services exacerbates social problems by promoting promiscuity and unintended pregnancy, when in fact, the exact opposite is true. They promote abstinence-education and marriage promotion programs that have been tried before and been discredited, because they simply do not work.

This conflict was front and center last week as the U.S. Supreme Court heard 90 riveting minutes of argument in Sebelius v. Hobby Lobby Stores, Inc. and Conestoga Wood Specialties Corp. v. Sebelius, a pair of cases brought by two privately held corporations owned by Christian conservatives. The owners claim that the ACA violates the religious freedom of employers forced to cover the costs of contraception. Much of the testimony turned on technical questions of whether corporations, as opposed to the individuals who own them, legitimately have rights to assert in this instance, and whether they may impose those rights on employees who don’t share their views. There were also important matters of scientific integrity at stake, with the plaintiffs claiming that Intrauterine Devices (IUDs) and morning-after pills constitute methods of abortion, despite overwhelming medical agreement and numerous reputable scientific studies showing that, like everyday birth control pills, they only act to prevent conception.

All but lost in the court’s conversation were larger concerns about the health and well-being of women and families – and of our society as a whole. The Supreme Court hearing comes in the wake of more than three years of persistent attacks by extreme conservative lawmakers who have already decimated publicly subsidized services in states across the country and left many low-income women without access to basic family planning and to other critical reproductive and maternal health care services.

As legal scholar and policy analyst Dorothy Roberts observed, “When access to health care is denied, it’s the most marginalized women in this country and around the world who suffer the most—women of color, poor and low-wage workers, lesbian and trans women, women with disabilities… And this case has far-reaching consequences for their equal rights. Birth control is good health care, period.”

Today, by government estimates, more than 27 million American women already benefit from the ACA’s contraceptive mandate, and 20 million more will enjoy expanded coverage when the law is fully implemented. Yet even by these optimistic assessments, many low-income women will continue to fall through insurance gaps, partly thanks to a 2012 Supreme Court ruling that enables states to opt out of Medicaid expansion mandated by the ACA. More than 3.5 million – two-thirds of poor black and single mothers, and more than half of low-wage workers – will be left without insurance in those states.

Conservative opposition to contraception is not new. As we observe in our paper, the U.S. controversy over family planning dates back to Victorian-era laws that first defined contraception as obscene and outlawed its use. Those laws carried the name of Anthony Comstock, an evangelical Christian who led a nearly 50-year crusade to root out sin and rid the country of pornography, contraceptives, and other allegedly “vile” materials that he believed promoted immorality. Sound familiar?

It took nearly a century for the U.S. Supreme Court to reverse course and guarantee American women the right to use contraception under the constitutional doctrine of privacy first enunciated in 1965. The ACA promises us even more. It places an affirmative, positive obligation on government to provide women the resources to realize our rights. The question before us is simple: Do we turn back the clock and allow a new Comstockery to prevail, or do we move ahead into the 21st century by defending the full promise of the Affordable Care Act’s contraceptive mandate?

Read Ellen and Andrea’s paper, “Breaking the Cycle of Poverty: Expanding Access to Family Planning,” here.

Ellen Chesler is a Senior Fellow at the Roosevelt Institute and author of Woman of Valor: Margaret Sanger and the Birth Control Movement in America.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States. You can follow her on Twitter @dreaflynn.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

Photo: WeNews via Flickr

Companies Are Not Churches, And Must Conform To Modern Laws

Companies Are Not Churches, And Must Conform To Modern Laws

What do contraceptives have to do with religion?

As a liberal Protestant, I see no connection — but that’s beside the point. There are plenty of sincere Catholics and conservative Protestants who believe the use of contraceptives, or at least some types of them, is sinful. That’s reason enough to be careful about any broad government regulations involving birth control.

Religious liberty is a cornerstone of the American way of life, a fundamental principle of the U.S. Constitution. The Founding Fathers were close enough to the bloody religious wars in Europe to try to found a country safe for pluralism, respectful of all religions while requiring none. If there is any such thing as American exceptionalism, freedom of religion is certainly one of its hallmarks.

Still, no Constitutional freedom is limitless. For more than a century, jurists have restricted religious liberties when they interfered with other important values. The Supreme Court did so as early as 1879, when it ruled against polygamy, practiced by some Mormons at the time.

That’s why the U.S. Supreme Court ought to rule against two corporations whose owners are fighting the requirement — a tenet of Obamacare — that employers’ health insurance plans pay for birth control. If businesses are given an exemption from a valid law that serves a useful public purpose because they claim it violates religious beliefs, where would it end?

(I’m leaving it to others to argue the perfectly valid point that corporations don’t have religious beliefs. They are not people. How many corporations have you ever seen sitting in the pews on Sunday?)

There are plenty of businesses and institutions that believe they have the right to fire gays and lesbians because homosexuality violates their religious beliefs. Some religious groups would keep outdated practices toward women, banning them from most high-powered jobs. While many people genuinely believe their God requires that, our civil society puts a premium on promoting equality.

If the two values are in conflict, individuals’ right to equality ought to win out. In a 1993 religious liberties case involving the use of peyote, Justice Antonin Scalia, himself a hyper-conservative Catholic, quoted from an earlier case when he wrote for the majority: “Can a man excuse his practices … because of his religious belief? To permit this would be to make the professed doctrines of religious belief superior to the law of the land, and in effect to permit every citizen to become a law unto himself.”

The case involving contraception is no different. The government has an overriding interest in ensuring that women’s health care is treated no differently from men’s, and reproductive services are vital. (As President Obama has noted, if men could have babies, contraception would already be a standard provision of all health insurance policies.)

For the record, laws have long been necessary to require health insurers to pay for certain procedures and pharmaceuticals. For example, the Georgia Legislature insisted in that 1990s that insurers pay for breast cancer screenings, which has helped to improve survival rates.

Since contraceptive use would help prevent abortions, religious conservatives ought to be among the most enthusiastic proponents of birth control coverage in health insurance. But one of the companies that opposes the law — Hobby Lobby, a chain of craft-supply stores — is owned by Southern Baptists who believe some forms of birth control, such as intrauterine devices, are tantamount to abortion. The other company involved in the Supreme Court case, Conestoga Wood Specialties, is owned by Mennonites who don’t believe in birth control of any sort.

The Obama administration has rightly compromised over religious objections to birth control mandates, exempting churches and other religious institutions. But corporations are not churches, no matter who owns them. Hobby Lobby and Conestoga Wood should be required to abide by the laws of a modern state.

Otherwise, where would this end? Bigotry operating under the auspices of the Bible could once again become the law of the land.

(Cynthia Tucker, winner of the 2007 Pulitzer Prize for commentary, is a visiting professor at the University of Georgia. She can be reached at cynthia@cynthiatucker.com.)

Photo: Nicholas Eckhart via Flickr

In Contraceptive Mandate Challenges, Women’s Health And Much More Is On The Line

In Contraceptive Mandate Challenges, Women’s Health And Much More Is On The Line

Despite significant existing accommodations for religious organizations, the current challenges to the contraceptive mandate could severely limit access to reproductive care.

On New Year’s Eve, Supreme Court Justice Sonia Sotomayor temporarily blocked enforcement of the Affordable Care Act’s (ACA) contraceptive mandate on a Colorado-based religious organization – Little Sisters for the Poor and Aged – paving the way for the heated debates on women’s health that will ensue in the year ahead.

The contraceptive mandate, which requires employers to provide full coverage of all FDA-approved contraceptive methods, has been a lightning rod since it was first introduced. Religious groups argued it violated their religious liberty, given their religious-based opposition to contraception. In response, President Obama modified the mandate by creating an “exception” that exempts houses of worship altogether, and an “accommodation” that enables organizations that identify as religious (such as Little Sisters) to opt out. Their employees can receive contraceptive coverage from a third-party insurer. These provisions should have put a quick end to the religious objections, but they didn’t.

In order to opt out of the contraceptive mandate, organizations must sign a form that certifies they identify as religious and acknowledges that either their insurance company or a third-party administrator will contact employees directly to provide coverage. Effectively, this provision removes the non-profit from coverage of birth control all together. However, Little Sisters argues that the simple act of signing that form constitutes a substantial burden on their religious liberty.

Here’s the kicker: All of this is moot because Little Sisters’ insurance company is run by the Christian Brothers, which is considered a church and is therefore exempt from adhering to the mandate. So while Little Sisters does have to sign the form for procedural reasons (and to prevent them from being fined for not complying with the mandate), the insurance company can – and likely would – legally refuse to provide the coverage.

While this specific case will have little impact on the employees of Little Sisters (who are out of luck either way), an ultimate ruling in the organization’s favor would provide more fuel to the anti-contraceptive mandate fire already raging across the country.

It also lays the groundwork for two cases already on the Supreme Court docket that will determine the future of contraceptive coverage. In those cases – Hobby Lobby and Conestoga Wood, to be heard on March 25 – the owners of private companies have asserted that providing contraceptive coverage for their employees is a violation of their religious liberty.  The Court will determine if for-profit groups actually have religious liberty, and – if yes – if the contraceptive mandate infringes on that liberty.  That decision will either guarantee contraceptive coverage to millions of women for the foreseeable future, or set a precedent where employers can use their personal religious beliefs as a basis for refusing coverage of a host of health services.

The 91 cases filed against the contraceptive mandate (46 from for-profit companies and 45 from non-profit organizations) reflect conservatives’ deep discomfort with women’s sexuality and their staunch opposition to facilitating – even in the slightest way – women’s sexual autonomy. The overwhelming acceptance and use of birth control among all American women means nothing. Indeed, 99 percent of sexually active women in America have used contraception, including nearly 90 percent of Protestants and Catholics.

All women should have access to comprehensive health services, including the full range of contraceptive options. For the majority of American women, access means affordability. For women in low- and minimum-wage jobs, dishing out $40 or more a month for birth control is simply not an option. Research has shown that in difficult economic times and when forced to pay out of pocket for birth control, women are more likely to use it intermittently or forgo it altogether, increasing their chances of unintended pregnancy. A 2009 study by the Guttmacher Institute showed that as a result of the 2008 economic downturn, 8 percent of women dispensed with birth control altogether and 18 percent used it inconsistently in order to save money.

These cases raise various legal questions to be answered by the courts, as well as serious ethical questions that we must consider. Do we want our bosses interfering in our personal medical decisions? Must we continue to allow reproductive health to be the one area of medicine to be adjudicated by the courts instead of our doctors?  If employers can use their position of power to infringe on access to birth control, what’s stopping them from denying access to other services that don’t suit their fancy? Could Scientologist employers deny access to psychiatric drugs? Could Catholic employers deny coverage for treatment of sexually transmitted diseases? It’s quite a slippery slope.

As it was originally written, the ACA treats family planning as the critical pillar of women’s health that it is. The Obama administration has gone above and beyond to accommodate the beliefs of religious organizations, and the court should now uphold this mandate that helps to make the ACA so transformative for the health of American women.

Andrea Flynn is a Fellow at the Roosevelt Institute. She researches and writes about access to reproductive health care in the United States and globally.

Cross-posted from the Roosevelt Institute’s Next New Deal blog.

The Roosevelt Institute is a non-profit organization devoted to carrying forward the legacy and values of Franklin and Eleanor Roosevelt.

AFP Photo/Saul Loeb