Now that the Supreme Court has determined two for-profit companies can claim religious exemptions to Obamacare’s birth control coverage requirement, low-income women will pay the price.
Not everyone is acknowledging that. Right-wing pundits have been quick to downplay the decision’s impact, claiming it won’t have any affect on women’s birth control access. “It’s no way going to prevent access to contraception,” Fox News contributor Charles Krauthammer said on Monday.
It’s true that the Obama administration may work with Congress to figure out some way to continue extending contraceptive coverage to the employees affected by Monday’s decision. But it’s not yet clear how that will work or whether it will be legal. In the meantime, the women who work at Hobby Lobby and Conestoga Wood are out of luck if they want coverage for one of the contraceptive methods their employers oppose — a reality that threatens to do real harm to impoverished women.
Hobby Lobby objects to covering two types of emergency contraception and two forms of intrauterine devices (IUDs), incorrectly asserting that those birth control methods can cause abortions. And even though Hobby Lobby supporters argue that women can just pay for their own birth control, footing the full cost of these particular contraceptives is no small feat for women who are struggling to make ends meet.
As Justice Ruth Bader Ginsburg pointed out in her scathing dissent to the 5–4 decision, “the cost of an IUD is nearly equivalent to a month’s full-time pay for workers earning the minimum wage.” Indeed, IUDs — which are the most effective form of birth control and the method that doctors are increasingly recommending — can cost more than $1,000 out of pocket. Before the Affordable Care Act took effect and began guaranteeing women’s access to no-cost birth control, many women didn’t use IUDs because the up front costs were too expensive.
We already have clear evidence about how removing cost barriers to the IUD can change women’s lives. A large 2012 study focusing on low-income women in St. Louis found that when they were given the choice between the full range of birth control methods without being charged a co-pay — the same choice that Obamacare’s contraceptive mandate offers — more of them opted for IUDs. And after that, fewer of them experienced unintended pregnancies and fewer of them got abortions.
On the other hand, without access to affordable long-lasting birth control, poor women are much more likely to struggle to avoid becoming pregnant. The unintended pregnancy rate for women living below the poverty level is more than five times as high as the rate for the women in the highest income level. When low-income women are faced with unplanned pregnancies, they often end up slipping even further into poverty. Thanks to the increasing number of restrictions on abortion — after all, conservatives like Hobby Lobby don’t want insurance plans to cover it — impoverished women often can’t afford to end a pregnancy. And there isn’t exactly a social safety structure in place to make it easier for them to afford a child, either.
Hobby Lobby pays its full-time employees $14 an hour, which works out to be $560 a week before taxes. Part-time employees make about $9 an hour. The company’s supporters could argue that the women making those salaries aren’t below the poverty line. But the issues with Monday’s ruling go deeper than that.
By successfully arguing that company owners’ right to religious conscience trumps women’s right to contraceptive access, Hobby Lobby has helped further the myth that birth control isn’t a critical part of health care. It’s a victory within the larger context of chipping away women’s access to contraception and abortion — a war on reproductive services that has already had devastating impacts on low-income women and communities of color. By conflating birth control and abortion, and arguing that these services are mostly about “recreation” and women’s health advocates are just “whining,” Hobby Lobby supporters are making it clear that women’s reproductive systems are their own problem.
It’s not hard to see the potential ripple effects. First of all, dozens of other companies and nonprofits have already sued to for the right to drop coverage for birth control, and the Supreme Court has opened the door for even more companies to file suit in the future. Hobby Lobby’s win paves the way for those businesses to be successful.
And more broadly, the rhetoric at the heart of the Hobby Lobby case has already made its way into legislative battles. Just last month, an Ohio lawmaker proposed taking away women’s public health coverage for IUDs, citing the same junk science that Hobby Lobby used to claim they’re a form of abortion. Now that emergency contraception is available over the counter, state legislatures have quickly introduced measures to restrict it. Publicly funded family planning programs have faced rounds of budget cuts and Republicans have attempted to drive Planned Parenthood out of businesses. Last fall, some conservatives even started worrying about the taxpayer dollars that are “picking up the tab” for unwed mothers’ maternity care.
The message is clear: women don’t deserve any help funding their sex lives, and it’s just too bad if they can’t afford it otherwise. The Hobby Lobby ruling may not have immediately affected every single American woman’s health care plan. But it will still help shape the society they have to live in.