On Monday, the Supreme Court ruled in favor of two for-profit businesses that object to covering certain types of birth control, determining that family-owned companies should be able to seek exemptions to Obamacare’s contraceptive mandate based on their owners’ religious beliefs. The reproductive rights community is condemning the decision for setting a dangerous precedent for women’s health care.
Indeed, by siding with Hobby Lobby and Conestoga Wood Specialties, the country’s highest court effectively validated some of the plaintiffs’ problematic arguments about contraception. Monday’s ruling affirmed three claims about birth control that simply aren’t true:
1. Birth control is the same thing as abortion.
The entire legal challenge against the Obama administration was based on the fundamental lie that certain types of FDA-approved contraception can end a pregnancy. The plaintiffs in this suit took the unscientific stance that pregnancy begins at fertilization and certain types of contraception, like the morning after pill and IUDs, are “abortion-inducing” because they prevent the implantation of a fertilized egg. But according to the legal definition of pregnancy, a woman is not actually considered to be pregnant until a fertilized egg is implanted in her uterine lining — so anything that inhibits ovulation, fertilization, or implantation is defined as birth control. And on top of that, there’s evidence that those types of contraception don’t actually prevent implantation in the first place.
The justices who joined the Court’s 5-4 opinion didn’t appear to be concerned about scientific evidence, however. Monday’s decision, written by Justice Samuel Alito, simply allows the business owners to follow their own definition of abortion. “The owners of the businesses have religious objections to abortion, and according to their religious beliefs the four contraceptive methods at issue are abortifacients,” he writes. “If the owners comply with the HHS mandate, they believe they will be facilitating abortions.”
Without challenging the plaintiffs’ definition of what constitutes an abortion or an abortion-inducing drug, the Supreme Court has essentially allowed unscientific beliefs about birth control to carry the weight of the law.
2. Birth control should be separated from other types of medical services.
Hobby Lobby opponents have been concerned about the case’s implication for services beyond contraception, pointing out that other companies might cite their religious beliefs to refuse coverage for vaccinations, blood transfusions, or services for transgender individuals. The Court briefly attempted to quell those concerns, specifying that Monday’s decision “concerns only the contraceptive mandate” and shouldn’t be interpreted to apply to other services like vaccines.
That’s perhaps well-intentioned, but it brings up questions about what exactly makes birth control different from those other health services. Why should it be singled out? Why do female employees need a workaround to access their reproductive health care? Why are employers allowed to refuse coverage for services that solely affect women, but not other medical interventions that serve the public good, like vaccinations?
“It is completely inappropriate and unacceptable for women to be expected to look to some special out of the usual way of accommodating what is a core and basic health care need,” Marcia Greenberg, the co-president at the National Women’s Law Center, said in a statement provided to Vox regarding the Hobby Lobby decision.
This artificial divide already exists between abortion services and the rest of women’s health care, and it’s something that has effectively undermined women’s access to abortion. Segregating birth control in this way threatens to have similar consequences for the 99 percent of U.S. women who use contraception at some point in their lives.
3. It’s easier for the government to pay for people’s birth control so that companies don’t have to.
In his opinion, Alito suggests that the government could simply “assume the cost of providing the four contraceptives to women unable to obtain coverage due to their employers’ religious objections.” That may sound like a reasonable compromise. But in the context of our current insurance system, it doesn’t necessarily make much sense.
First of all, as Amanda Marcotte argues in RH Reality Check, separating out everyone’s birth control coverage from the rest of their private insurance plans actually could make things much more complicated within our employer-sponsored insurance model. Insurers would need to implement new billing processes. Women may need to make a special “contraception only” trip to the doctor to get their government-funded prescriptions filled. The myth that birth control is somehow different from the rest of women’s health care would become even further entrenched.
And, as Justice Ruth Bader Ginsberg writes in her dissent to Monday’s opinion, the government’s safety net system for affordable contraception can’t necessarily accommodate more women. The Title X program is currently the publicly-funded family planning program that’s supposed to help low-income women afford their reproductive health care. But it’s been plagued with rounds of budget cuts in states across the country — often led by Republican lawmakers who oppose the idea of taxpayer funded birth control — and it’s struggling to provide care for all the women who need help. As a result, unintended pregnancies have become increasingly concentrated among poor women who lack access to birth control.