Women, not employers, should decide about contraceptives

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The U.S. Supreme Court will hear legal arguments Tuesday about whether a boss’s religious beliefs can trump a woman’s own beliefs and her access to the health care she seeks.

The Affordable Care Act requires all new employer and other health insurance plans to cover birth control and related counseling with no out-of-pocket expense for the woman as part of women’s essential preventive health care, with exceptions only for religious plans and employers.

Hobby Lobby, a nationwide chain of nearly 600 arts and crafts stores with more than 13,000 employees, and Conestoga Wood Specialties, a furniture and kitchen cabinet manufacturer with nearly 1,000 employees, are asking the Supreme Court to exempt them, and for-profit corporations generally, from providing any health care that violates religious beliefs they ascribe to the corporation — in this case, contraception.

While these companies—and the approximately 50 others that have filed similar lawsuits — are pressing their case in a very public and high-stakes forum, the voices of the actual women who stand to lose critical health coverage have generally not been heard.

A letter sent to the National Women’s Law Center by an employee at Hobby Lobby explains why. She was willing to share her story “IF and only IF my name remained anonymous. . . . I would not like to be fired over this. We are a single-income family, and if I were to lose my job over something like this, we would probably be on the streets.” She is not the only employee who worries about the risks of speaking out.

So much is at stake for her and the thousands of other women who toil as cashiers, craft instructors or store managers at Hobby Lobby, cabinet-makers at Conestoga Wood and in other jobs at these and other companies. The Hobby Lobby employee explains, “Birth control coverage should be important for everyone, not just women. . . . And without birth control I could have been pregnant a lot sooner than I would have liked. . . . I think it should be readily available for any woman that wants to take responsibility [for] her life.”

The impact of this decision could be huge. Under the new law, more than 27 million women are already eligible for health insurance coverage of the full range of FDA-approved contraception without cost, improving their access to the safest, most effective form of birth control for them.

A woman whose doctor prescribes an IUD to avoid the side effects of hormonal contraception, for example, faces upfront costs from $500 to $1,000. Moreover, the IUD, a form of contraception to which these companies specifically object, is one of the most effective forms of birth control — more than 20 times more effective than the pill. Were Hobby Lobby, Conestoga Wood and other businesses supporting their position to prevail, women would face substantial cost barriers to securing this important health care.

Studies show that eliminating the cost barriers to contraceptives greatly reduces the frequency of unintended pregnancy, which, in turn, protects the health of women and their children. Women who can space their pregnancies have healthier children, are more likely to receive prenatal care and are less likely to suffer from depression or domestic violence.

Access to contraception also improves a woman’s odds of completing school and securing a well-paid job. Indeed, studies find that the availability of contraception has been a key driver in narrowing the wage gap and increasing the representation of women in many professions over the last half-century.

There’s a name for excluding one of the most important and commonly used preventive health services for women while covering the full range of preventive care for men: sex discrimination. And there’s a real-world consequence of that discrimination to women’s health and to their futures.

Allowing for-profit employers to impose their religious beliefs on their employees is not the American way. Nor is giving bosses the right to provide comprehensive preventive health coverage for men while picking and choosing what they will cover for women. Women — whether they work at Hobby Lobby, Conestoga Wood or any other company — not only deserve better, but the law ensures that they will get the health coverage they need. Now it’s up to the Supreme Court to respect current law and women’s right to exercise their own religious beliefs and to secure the health care best for them.

Marcia D. Greenberger is co-president of the National Women’s Law Center, which filed an amicus brief on behalf of itself and 68 other organizations that support the contraceptive coverage benefit.

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