In July 2020, the Supreme Court voted 7-2 to uphold the Trump administrations regulation to allow private employers the option of denying contraceptive coverage as part of their healthcare plan, if they have “sincere religious or moral objections"
This ruling, which passed due to the conservative stronghold currently weighing down the right side of the bench, further dismantles the Affordable Care Act (ACA), which required that insurers provide birth control as basic preventative care in nearly all healthcare plans. The decision is the latest casualty in the congressional battle to determine whether or not birth control should fall under the jurisdiction of healthcare (it should).
In 2010, after a slew of heated hearings, the ACA was modified to allow opt-out accommodations for religious organizations. Since then, the current administration has chipped away at the mandates, expanding the types of businesses who could opt out and eliminating measures to protect the insured employees of employers who cried exempt. As of July’s ruling, any employer with a moral objection can deny coverage, which leaves women across the country at a grim fork in the road – either put your reproductive health in the hands of your boss’ beliefs, or pay out of pocket for birth control.
The decision could result in over 126,000 women losing their contraceptive coverage. Furthermore, the out of pocket cost barrier disproportionately affects women from lower socioeconomic backgrounds. Before the ACA went into effect, 55% of women between ages 18-34 reported having struggled to cover the cost of birth control.
Strip away the bureaucratic plot twists of the past decade and the question at the heart of this fight remains: why doesn’t birth control qualify as basic preventative health care? And why, in 2020, when birth control has proven its undeniable and irreplaceable role in reproductive health, are we still arguing about this?
Other tenets of reproductive health, such as pregnancy, childbirth, and newborn care, are typically covered under healthcare plans - what makes birth control different? Access to birth control prevents unintended and unhealthy pregnancies, which makes pregnancies safer across the board. It also allows women critical agency over their bodies, their sex lives, and their futures. Modern contraception has had such a profound effect on family planning that the CDC named it as one of the top ten public health achievements of the past century.
Beyond the prevention of pregnancy, birth control is regularly prescribed to treat a variety of health concerns, a facet of the fight that is often overlooked. Hormonal birth control is used to regulate painful periods, treat hormonal acne, and manage the symptoms of chronic conditions such as PCOS, PMDD, and endometriosis. The Pill has also proven effective in reducing the risk of ovarian and uterine cancer. In many situations, for many women, birth control acts as a much-needed medical safeguard. Is that not healthcare?
What’s next for the battle over birth control? Joe Biden has vowed, if elected, to once again limit exemptions to houses of worship and nonprofits with religious missions, returning birth control to healthcare plans. 2021 marks 60 years since the Pill became widely available, sparking a fight for the right to reproductive freedom that has lasted for generations. The question that remains is how much longer can it rage on?
Written by Alison Green