Hobby Lobby: Science Fiction Trumps Women’s Health

The Supreme Court’s majority decision in the case of Hobby Lobby et al. presents serious threats to women’s rights, to the public’s health and the public order. Efforts to override the decision at the state and federal levels require energetic support.

 

As the dissent by Supreme Court Justice Ruth Bader Ginsburg, supported by dissenting Justices Breyer, Kagan, and Sotomayor, notes, “In a decision of startling breadth, the Court holds that commercial enterprises, including corporations…can opt out of any law (saving only tax laws) they judge incompatible with their sincerely held religious beliefs.”

The troubling ruling specifically grants a wide range of for-profit corporations the right to opt out of the federally mandated requirement to provide all FDA-approved contraceptives to employees through their health insurance plans, without co-payments and deductibles. If tolerated and uncontested, the ruling will:

  • Re-instate financial barriers to the most expensive forms of contraception, which are also the most effective;
  • Stigmatize contraception, which will depress effective use;
  • Eliminate discussion of the negative impact on the health and interests of the people most affected, employees and women, by assigning human characteristics and religious beliefs and rights to corporations, which are by design a legal fiction.

Cost and stigma are barriers to health

 

Contraception is widely used and recognized as “a fundamental health care service and a basic public health measure.  The ability to plan, start, space, and discontinue bearing children has transformed everyday life for women, families, and communities. Along with other improvements in medical care and public health, it has vastly enhanced women’s autonomy, professional and educational achievement, and emotional satisfaction and helped extend their life span… Mandates requiring wider insurance coverage for birth control are associated with more consistent use of contraception.”[1]

 

The major U.S. medical and health care professional associations recommend access to all FDA-approved contraceptive drugs and devices to safeguard the health of women, to reduce unintended pregnancy, as well as to protect the health of women for whom pregnancy may be hazardous, even life threatening.[2]

From 2008-2011, the rates of pregnancy, births and abortions all declined steeply in the U.S.  “Contraceptive use improved during this period, as more women and couples were using highly effective long-acting reversible contraceptive methods, such as the IUD.” [3]

However, many women report that cost is a barrier to obtaining and using birth control consistently. Insertion of an IUD, the most reliable reversible form of birth control for women who tolerate it physically, and who choose it, can cost $1,000.

Sharp inequalities in the rate of unintended pregnancy persist, remaining 5 times higher for low-income women and women of color compared with higher-income and white women. Almost half of all pregnancies in the United States are unintended – an exceptionally high rate.[4]  The ACA requirement waiving cost-sharing is essential.

In its 2011 final report of recommendations for women’s preventive health services to be included under the Affordable Care Act, ‘Clinical Preventive Services for Women: Closing the Gaps‘, the Institute of Medicine (IOM), found that stigmatizing access and coverage would increase even further the high rate of unintended pregnancies, and discriminate against women.

The Hobby Lobby owners believe that 4 selected methods of contraception are abortifacients.  This is scientifically wrong in 3 cases, and questionable in a fourth.   Nevertheless, Justice Alito says for the Court, on pp. 37-8:  “it is not for us to say that their religious beliefs are mistaken or insubstantial,” as long as they reflect “an honest conviction.”

Granting for-profit corporations protection as religious minorities

The Hobby Lobby decision is startling in the absence of analysis of its likely negative impact on the health of the women employees for whom four effective and expensive contraceptives will no longer be available through their employer’s health insurance plans.  Worse, the argument that won the day for the corporation would apply even if the corporation were opposed to providing any and all contraceptives to employees.

The Supreme Court decision fundamentally redefines corporations in a manner that privileges the views of business owners over those of other citizens.

A corporation is in essence a legal fiction, created to facilitate the business activities and purposes of groups of people by shielding them as individuals from the risk of liability that is the inevitable consequence of a business enterprise.  The majority decision in Hobby Lobby, however, confounds this definition.  It claims that a for-profit corporation can in fact have religious beliefs, because it is no more than an “association of a group of people.”

The legal standard developed by an earlier Supreme Court to protect “discrete and insular” religious minorities requires that the “least restrictive” course of action be taken to comply with a law.

The current decision analyzes the potential harm to Hobby Lobby from complying with the ACA’s contraception mandate strictly in terms of whether or not its religious objection to that law is sufficiently accommodated.  The equation essentially asks, is the mandate to move corporate funds from one corporate bank account to an insurance company’s bank account more or less burdensome to the corporation’s preferred religious belief about contraception, compared with, for example, moving some of the corporation’s funds into its payment of taxes, and having the government cover some of the cost of the mandate?

Remember this?

The Court’s decision does not factor in the impact of the employer’s benefits choices on the vast majority of individuals who are not a corporation, but use contraceptives.

For these reasons and for the public health’s sake, efforts must be initiated and supported to override the decision by enforcing the mandate at the state and federal levels that health insurance plans must cover the full range of FDA-approved contraceptives at no additional cost to the individual.

 

 



[1] Shaffer ER, Sarfaty M, Ash AS. Contraceptive insurance mandates. Med Care. 2012 Jul;50(7):559-61.

[2] Jones R and Jerman J. Abortion Incidence and Service Availability in the United States, 2011. Guttmacher Institute. Feb, 1, 2014. http://www.guttmacher.org/media/nr/2014/02/03/

[3] Jones R and Jerman J. Abortion Incidence and Service Availability in the United States, 2011. Guttmacher Institute. Feb, 1, 2014. http://www.guttmacher.org/media/nr/2014/02/03/

[4] National Survey of Family Growth (Finer and Henshaw, 2006); cited in IOM (Institute of Medicine). 2011. Clinical Preventive Services for Women: Closing the Gaps. Washington, DC: The National Academies Press, p. 102.

Buffer Zones, Hobby Lobby, and Prof. Tribe

Sticks and stones can break our bones, and too many women know that sometimes words are just the opening act.

Last week the Supreme Court invalidated a Massachusetts law that creates a 35-foot buffer zone of safety to shield women entering abortion clinics from the vituperative abuse hurled by anti-rights protesters.  According to the National Abortion Fund, these protesters too frequently have turned violent.

The buffer zone decision is not our friend.  But the decision does not require us to concede, as  Laurence Tribe pompously proclaimed in Friday’s NY Times, that “neither empathy for [abortion partients’] anguish, nor the need to protect the safety of women seeking such services, nor the clear need to guard against the rising tide of state laws designed to restrict access to abortions, can justify far-reaching measures that restrict peaceful conversation in public spaces.”

According to USA Today, “The court ruled unanimously that Massachusetts went too far — literally — when it created 35-foot buffer zones around abortion clinics to keep demonstrators away from patients.

“The decision united Chief Justice John Roberts and the court’s four liberals, who said the distance improperly removed demonstrators from public sidewalks and spaces. The other conservative justices would have issued a more sweeping verdict, striking down the ban on grounds that it targets abortion opponents’  specific point of view.”

There will be much more to say about all this starting on Monday, when we learn whether and how the Court refrains from sacrificing its legitimacy in the Hobby Lobby case, which asks to assign religious beliefs to corporations, and on that basis grant corporations the right to reject scientific evidence and to deny its employees legally mandated coverage for contraception.

These cases challenge us to confront the complex web of factors that the law and advocates invoke to defend reproductive rights.  The ruling and other U.S. laws confuse money, ownership and privacy with women’s basic rights to safety, health, autonomy, self-determination and equal, non-discriminatory treatment; and the  government’s obligation to protect those rights.

We have to assert the strategies that have achieved progress to date: creating wide consensus in the court of public opinion that isolates and stigmatizes the beliefs, language and acts that undermine us, as well as winning legal remedies where possible, and .

We accept that verbal or physical sexual harassment is illegal at work, in part because it creates a hostile environment that discriminates against women.

But we’ve taken additional routes to isolate, stigmatize and suppress harmful speech and actions that are not necessarily illegal.  We’ve severely curbed the need for women to mentally teleport to a distant planet when walking past a construction site, in part by integrating the workforce, and in part by confronting men on the Neanderthal catcalling that too often ensued.  Real threats persist.  But, for example, Donald Sterling’s repugnant racial views and comments, undoubtedly long tolerated in private, met with swift justice in the court of public opinion once aired and confronted publicly.

Threats and acts of violence against patients are not tolerated inside any medical institution, and we cannot tolerate it en route.

Massachusetts should immediately replace and strengthen the buffer zone law, and Governor Deval Patrick and AG Martha Coakley have pledged to do so.

Laurence, honey, go soak your head.

The rest of us, let’s analyze the complex conditions we face, speak up, and mobilize in the interest of safety, health, and justice.

What’s Next?

#EveryWoman, The Hobby Lobby Case, and The Supreme Court

#EveryWoman at the Supreme Court

#EveryWoman 

As the Supreme Court Justices deliberate, #EveryWoman aims to make sure that they know the mainstream views and practices of Americans regarding birth control. Women’s access to affordable contraception, that is responsive to each woman’s health and life conditions, is a fundamental right with widely accepted health benefits.

Public discussions around the Hobby Lobby and Conestoga Wood cases have sometimes been shrouded in technical debates over interpretations of the Religious Freedom Restoration Act.

In the words of Justice Kagan, regarding the Affordable Care Act:  Congress has given a statutory entitlement and that entitlement is to women and includes contraceptive coverage.

Whatever the Court decides, the Trust Women/Silver Ribbon Campaign and our supporters aim to assure that this access continues.

The Hobby Lobby Case

The Affordable Care Act as adopted in 2010 required all health insurance plans to cover contraception as a preventive health benefit for women, without any additional copayments or deductibles. But some religious groups opposed this provision, primarily the U.S. Conference of Catholic Bishops and some evangelical Christian groups.  The final regulations issued in 2013 provided exemptions from the contraception coverage mandate to a wide assortment of employers, including those that admittedly hire employees of other faiths.   Numerous private employers followed suit by seeking an exemption from the law, based on the religious beliefs of the owners.  Lower courts issued a variety of conflicting rulings.  The Supreme Court agreed to hear the case presented by two such corporations, Hobby Lobby and Conestoga Wood. The case was presented on March 25, 2014, and a decision is expected towards the end of June.

The owners of these 2 for-profit corporations assert that their personal religious beliefs are also held by their corporations. Those beliefs compel them to want to offer health insurance to their employees, and they agree to include coverage of contraceptives. However, their beliefs also include opposition to abortion.  They mistakenly believe that certain contraceptives cause abortions, in preventing a fertilized egg from implanting in the uterus wall.  Science has shown that, instead, these methods prevent fertilization.  If Hobby Lobby and Conestoga  Wood can legitimately avoid following the law due to these claims, it could destabilize a range of other laws.

Selected excerpts from the transcript of the hearing in March demonstrate the Justices’ range of views.

JUSTICE KAGAN: Justice Sotomayor is quite right that there are quite a number of medical treatments that different religious groups object to. So one religious group could opt out of this and another religious group could opt out of that and everything would be piecemeal and nothing would be uniform. (p.6)

JUSTICE KAGAN: But, again, Mr. Clement, as Justice Ginsburg said, this was a very uncontroversial law. Your understanding of this law, your interpretation of it, would essentially subject the entire U.S. Code to the highest test in constitutional law, to a compelling interest standard. So another employer comes in and that employer says, I have a religious objection to sex discrimination laws; and then another employer comes in, I have a religious objection to minimum wage laws; and then another, family leave; and then another, child labor laws. And all of that is subject to the exact same test which you say is this unbelievably high test, the compelling interest standard with the least restrictive alternative. (p.14)

JUSTICE KAGAN: Well, with respect, Mr. Clement, I think that … the Court has had a different understanding of what the Religious Freedom Restoration Act does and the kind of analysis that it requires courts to perform than you’re arguing for in this case. …if your argument were adopted and there was a strict scrutiny standard of the kind that usually applies and a least restrictive alternative requirement, then you would see religious objectors come out of the woodwork  with respect to all of these laws. And because you say — and I think this is absolutely right when you say it — that you cannot test the centrality of a belief to a religion, you cannot test the sincerity of religion. I think a court’s hands would be bound when faced with all these challenges if your standard applies. (p.16)

JUSTICE KAGAN: But Mr. Clement, it’s not saying you must do something that violates your religion. It’s giving you a choice. You can do this thing or if this thing violates your religion you can do another thing. And that other thing is approximately the same price as the thing that you don’t want to do. (p.25)

JUSTICE KAGAN: I mean, Mr. Clement, isn’t that just a way of saying that you think that this isn’t a good statute, because it asks one person to subsidize another person. But Congress has made a judgment and Congress has given a statutory entitlement and that entitlement is to women and includes contraceptive coverage. And when the employer says, no, I don’t want to give that, that woman is quite directly, quite tangibly harmed. (p.37)

JUSTICE GINSBURG: It would make no difference if it were — there are 20 FDA-approved contraceptives, all of them covered by the Healthcare Act. (p. 38)

JUSTICE GINSBURG: You picked out, in one case, three, and the other case four? Suppose the employer says contraceptives all together are against my religion, so I’m not going to give any contraceptive coverage. (p. 38)

JUSTICE GINSBURG: But your argument, it seems to me, would apply just as well if the employer said no contraceptives.

JUSTICE SOTOMAYOR: Is your claim limited to sensitive materials like contraceptives or does it include items like blood transfusion, vaccines? For some religions, products made of pork? Is any claim under your theory that has a religious basis, could an employer preclude the use of those items as well? (p.4)

JUSTICE SOTOMAYOR: How does a corporation exercise religion? I mean, I know how it speaks and we have, according to our jurisprudence, 200 years of corporations speaking in its own interests. But where are the cases that show that a corporation exercises religion? (p.18)

JUSTICE SOTOMAYOR: So the dissent in this case, in the Tenth Circuit case, said how do we determine when a corporation has that belief? Who says it? The majority of shareholders? The corporate officers? The — is it 51 percent? What happens to the minority? And how much of the business has to be dedicated to religion? 5 percent? 10 percent? 90 percent? Just assume not a business like yours – you picked great plaintiffs, but let’s assume — Let’s assume just a business that sells 5 percent of religious books, doesn’t play Christmas music, doesn’t give off – works on Sunday, you know, does nothing else religiously. (p.18)

JUSTICE SOTOMAYOR: Is there — a different way of looking at it, the leeway? In U.S. v. Lee, we said, “When followers of a particular sect enter into a commercial activity as a matter of choice, the limits they accept on their own conduct as a matter of conscience and faith are not to be superimposed on the  statutory schemes which are binding on others in that activity.” So isn’t that really the answer, that we’ve never considered a for-profit corporation as exercising religion? (p.20-21)

CHIEF JUSTICE ROBERTS: I thought that part of the religious commitment of the owners was to provide health care for its employees.

JUSTICE SOTOMAYOR: Well, if they want to do that, they can just pay a greater salary and let the employees go in on the exchange. (p.23)

JUSTICE SOTOMAYOR: May I just put a footnote on this. I thought the average price of providing insurance for a single person is $4,000, and it’s $12,000 for a family — for a family. So the $2,000 tax — that’s what it’s called — is to help the government provide subsidies to people on the exchange that don’t have employer insurance. So it’s a tax because it is to do exactly what your client wants, to get the government to supply the contraceptives, not the insurance companies. (p. 26)

JUSTICE SOTOMAYOR: Counsel, one of the attorneys below on behalf of your clients admitted that the grandfathered policies weren’t going to be around very long because any change to an existing policy [terminates such plans] — and he said these changes happen on a yearly basis. And we already know from the government’s statistics that up to 40 percent now have grandfathered out. Your own client changed its policy, and that’s why it’s not grandfathered. And he changed it to drop contraceptives it was covering. (p.31)

JUSTICE SOTOMAYOR: I’m not sure that squares with Lee. The statute created the right to Social Security, and there the Court said you can’t deprive employees of a statutory right because of your religious beliefs. So Lee is contrary to the point you’re making. (p.35)

JUSTICE SOTOMAYOR: So we go back to the start of my question, that would be essentially the same for vaccines, blood transfusions, non-pork products, the government has to pay for all of the medical needs that an employer thinks or claims it has a religious exemption to? (p.84)

CHIEF JUSTICE ROBERTS: Isn’t that what we are talking about in terms of their religious beliefs? One of the religious beliefs is that they have to pay for these four methods of contraception that they believe provide abortions. (p.76)

JUSTICE SCALIA: There is not a single case which says that a for-profit enterprise cannot make a freedom of religion claim, is there? (p.50)

JUSTICE SCALIA: You’re talking about, what, three or four birth controls, not all of them, just those that are abortifacient. That’s not terribly expensive stuff, is it? (p.66)

JUSTICE ALITO: What about the implications of saying that no for-profit corporation can raise any sort of free exercise claim at all and nobody associated with the for-profit corporation can raise any sort of free exercise claim at all?

Let me give you this example. According to the media, Denmark recently prohibited kosher and halal slaughter methods because they believe that they are inhumane. Now, suppose Congress enacted something like that here. What would a corporation that is a kosher or halal slaughterhouse do? They would simply — they would have no recourse whatsoever. They couldn’t even get a day in court. They couldn’t raise a RFRA claim. They couldn’t raise a First Amendment claim. (p.78)

The Supreme Court

 

Supreme Court  Basics

The Supreme Court includes 9 justices, appointed for life. Each Justice is nominated by the president who is in office at the time a vacancy occurs, usually due to the resignation or death of another justice, and must be approved by a vote of the Senate.

The Court is part of the judiciary, one of the three branches of the U.S. government.  The other two branches are the Executive (president, who appoints the heads of U.S. agencies, such as the Dept. of Health and Human Services); and the legislature, including Congress.

The role of the Supreme Court is to decide whether particular laws or regulations adopted by local, state or federal legislatures or regulatory authorities are consistent with the U.S. Constitution.

Supreme Court decisions have played a key role in expanding access to contraception and abortion.  In Griswold v. Connecticut in 1965, the court found that the Constitution protected a right to privacy, striking down a state law that restricted unmarried people from obtaining contraceptives, followed by the Roe v. Wade decision in 1973, that legalized abortion.

The Justices are supposed to be nonpartisan.  They are generally considered to be divided on reproductive rights.

All of the Justices who are married appear to have used contraception regularly, as each has 3 or fewer children, except for Scalia, who has 9. (details below.) http://www.supremecourt.gov/about/biographies.aspx

* See and Share EveryWoman on Facebook

* Follow #EveryWoman on Twitter

* Tweet about why access to affordable contraception is important, and share it with all of your followers.  Use #EveryWoman, and tell @SCOTUS and @oursilverribbon!

* Advocate Action: Sign and comment on our PETITION

 

Tell the Supreme Court THIS WEEK: Losing Affordable Contraception Would Harm Women (LikeMe!)

 

Who Is EveryWoman

 

EveryWoman Visits Her Doc

EveryWomans-First-Day

 

EveryWoman at the Supreme Court

Protest

The Supreme Court must stand with modern, mainstream America, and support women’s rights to coverage for birth control. The Affordable Care Act requires health insurance plans to cover birth control as a preventive benefit, without additional charges, a key step in reversing discrimination against women.

The Court must reject the extreme and unsupportable demands by the owners of two for-profit corporations, Hobby Lobby and Conestoga Wood, for the right to exclude coverage for certain contraceptives from their employees’ health insurance plans.

The owners assert they have this right because their corporations have a religious conscience, a novel claim. If they win, it could open a floodgate allowing employers to interfere in a wide range of personal decisions, and override other laws, including dropping coverage for any contraceptives.

Allies for women’s rights are raising our voices now, as the Justices consider this historic case. The Court is expected to issue a decision late in June.

TAKE ACTION NOW, AND EVERY DAY THIS WEEK, to tell the Supreme Court Justices that the American public is relying on them to reflect our mainstream, common sense views.  Contraception is a crucial health  benefit.  Women have the right to decide which method of birth control, if any, is best for us.  Period. 1. Add your comments and your voice on this petition.  Why is coverage for affordable birth control important to you?

2. Tweet about why contraception is important to you, and share it with all of your followers. Use #Everywoman, and tell @SCOTUS and @oursilverribbon!

Like #Everywoman, effective contraceptives enabled me to enjoy my education, work, and relationships. All essential! @SCOTUS@oursilverribbon

3. Follow the Trust Women/Silver Ribbon Campaign on Facebook and Twitter to receive updates.

4. Encourage your friends and family to participate!

The Facts About Contraception:

Contraception is a fundamental health care service, and a basic public health measure. The ability to plan, space, and discontinue bearing children has transformed everyday life for women, families, and communities. Along with other improvements in medical care and public health, it has vastly enhanced women’s autonomy, professional and educational achievement, and emotional satisfaction, and helped extend their life span.

Nearly 99% of all women have relied on contraception at some point in their lives, but more than half of all women between the ages of 18 and 34 have struggled to afford it. Inadequate access to contraception is a key reason why 50% of pregnancies in the U.S. are unintended.

There are many forms of birth control, with different degrees of effectiveness.  The pill, and barrier methods like condoms, may be more affordable, but harder to use consistently and reliably. Longer lasting methods like inserted intrauterine devices (IUDs) are more consistently effective, and are reversible, but are usually more expensive initially.  Some women may be discouraged from choosing these methods in response to discriminatory policies against women and communities of color, and lower-income communities. Mandates requiring wider insurance coverage for birth control are associated with more consistent use of contraception.[Magnusson BM, Sabik L, Chapman DA, et al. Contraceptive insurance mandates and consistent contraceptive use among privately insured women. Med Care. 2012;50:562–568.]

However, powerful opponents are attempting to turn back the important coverage the ACA provides, and deny women access to affordable birth control, by appealing to claims for employers’ “religious freedom.”

The owners of the corporations in the “Hobby Lobby” Supreme Court case seek to exclude 4 types of contraceptives from their employees’ health insurance, including Ella and Plan B. The corporate owners say that these drugs cause abortions.  As the NY Times reported in 2012, science has established that this is not true. For a more detailed refresher on how eggs and sperm get together to create babies, click on this video by ASAP Science.

The owners also say that this erroneous belief should be protected by the Supreme Court, and give them the right not to follow the law, because it is part of their religion.

They claim that the corporations share their personal religion.  Having to include coverage for types of contraception that violate the corporation’s religious beliefs would unduly burden the corporation’s religious rights.  And that this burden to the corporation’s beliefs is greater than the burden and discrimination their thousands of employees around the U.S. would suffer due to unaffordable birth control, and the ongoing stigma of reproductive health care services.

These are extreme arguments.

A corporation cannot have a religion. It is a legal creation, not a human one.

Women are people, and would experience tremendous harm to their health and their finances if the Supreme Court reverses the legal right to coverage for affordable birth control.

It would also increase the costs of health care and health insurance, including increasing unintended pregnancies.

Hobby Lobby’s Religion: Boko Haram

House of Reps All-Male Hearing on Contraception, 2012

Hobby Lobby today announced that although it is a corporation, it does indeed have a religion: Boko Haram.  When its Christian owners argued before the Supreme Court to assert their right to deny insurance coverage for 4 types of birth control on the basis of the corporation’s religious beliefs, Justice Sotomayor questioned “How does a corporation exercise religion?”  The Corporation itself has so far been silent on its actual religious affiliation.

“With so many of our successful practices under attack around the globe this month, we felt it was time to speak publicly in defense of our faith,” the Corporation said.  “On May 6, a Boko Haram leader claimed responsibility for abducting hundreds of Nigerian school girls, planning to sell them.  In the U.S., with legislation in Missouri and Louisiana aiming to strip abortion providers of their right to practice, and in Congress to ban abortions after 20 weeks, when low-income women and women with medical abnormalities are most likely to need them, our staunch doctrine of assuring the long-term, structural subservience of women has been making enormous strides.

“The firing of Jill Abramson for her ‘brusque’ management style as NY Times editor, to be replaced by the man who had responded entirely appropriately to her by punching a hole in the wall at the Times, was simply more than we could have hoped for.

“This cascade of previously unimaginable successes has of course inflamed uncontrollably whiny, emotional, and humorless feminist apparatchiks around the globe, from groups like a Billion Rising, and the Trust Women/Silver Ribbon Campaign.   These modern women and their supporters would convince the US Supreme Court that it’s time to set the record straight and dismiss Hobby Lobby’s arguments, simply because they reflect the last gasp of the backwards, fringe mentality we represent. And frankly, the recent denunciation of Boko Haram by Al Qaeda contributed to prompting our declaration. By coming out publicly to claim our corporation’s religious affiliation with Boko Haram, we intend to put all such diversions to rest.”

(The corporation went  on to explain how this unique circumstance entitled it to claim its independent right to assert that Plan B should not be covered by Hobby Lobby because it is an abortifacient, which is otherwise labeled by mainstream scientific evidence as “absolutely without any foundation whatsoever.”)

Severe Questions by Justices Ginsberg, Kagan, Sotomayor on Hobby Lobby

Supreme Court to Take Straw Poll on Extreme Case

Claiming that “any religion allowed to be practiced only inside a house of worship, and not in the day-to-day business of life, is a worthless faith,” evangelical pastor Rick Warren’s Washington Post op ed  calls on the Supreme Court to assign “religious freedom” to corporations, including the divinely authorized power to dictate and overrule the intimate personal health choices of the vast majority of Americans. Hobby Lobby, a multibillion-dollar business with more than 550 stores, seeks to deny health insurance coverage for contraception for its nearly 16,000 full-time employees.

As the Supreme Court nears a “straw poll” vote on this case, women and men across the country are speaking out in opposition to Mad Hatter-style extremism, and respecting women’s rights to make personal decisions about our health.
At the March 25 Supreme Court hearing, the three women Justices – Ruth Bader Ginsburg, Sonia Sotomayor and Elena Kagan – sharply questioned whether Hobby Lobby’s mega-corporate crafts chain has religious rights, and whether its owners may opt out of providing some forms of birth control to employees as a result.
On corporations and religious freedom: Justice Sotomayor: “How does a corporation exercise religion? I mean, I know how it speaks and we have, according to our jurisprudence, 200 years of corporations speaking in its own interests. But where are the cases that show that a corporation exercises religion?” (court transcript, p. 18)

On contraception coverage in the Affordable Care Act: Justice Kagan: …Congress has made a judgment and Congress has given a statutory entitlement … to women [that] includes contraceptive coverage. And when the employer says, no, I don’t want to give that, that woman is quite directly, quite tangibly harmed.” (court transcript, p. 37)

Denying some contraception coverage to employees is denying coverage to all contraception:
Justice Ginsburg: “…there are 20 FDA-approved contraceptives, all of them covered by the Healthcare Act…[to Hobby Lobby lawyer Clement] You picked out, in one case what, three, and the other case four? Suppose the employer says contraceptives all together are against my religion, so I’m not going to give any contraceptive coverage…your argument, it seems to me, would apply just as well if the employer said no contraceptives.” (court transcript, p. 38)

Public opinion matters. And we’re speaking out. Here’s what some supporters who have had enough are saying:

Contraception? Really? We’re re-doin’ the *!*!*! fifties here?
Maya Elashi, OakLand, CA

When will this madness end?
Stephanie Norliel Chico. CA

Only women should decide about women’s health issues. No boss or any men period.
Margo Westerlund, Chandler, AZ

My contraceptive choice is to be made by me after discussion with my doctor. This decision will not be made by my employer or the government!
Renee Carter, Falls Church, VA

Keep corporations out of my uterus. Separation of church and state is the law of the land. Neither churches nor corporations have the right to write laws.
Rebecca Kane, Goodells, MI

We must guarantee that women do not lose the right to make the best decisions for their bodies, their families and their lives. We will not give in to bullying, and stand united to protect women’s right to govern their own reproduction!
Suzanne Cowan, San Francisco, CA

Whether religious organizations or secular corporations, employers do not and ought not have the right to restrict the health care (and by extension, the health insurance coverage) of their employees. The only possible exceptions would be employees of religious organizations who have themselves taken some sort of holy orders, in other words they have dedicated their lives to a religion and vowed to obey the rules of a religious order. Free citizens must have the freedom to access health care without restrictions imposed by their employers that differ from the law of the land, no matter how strongly the people running the business or organization feel about contraception, abortion, or other legally sanctioned medical practices.
Nancy Dunn, Granby, CT

The only person with a right to impose religious beliefs on a woman is the woman herself.
Randi Kinman, San Jose, CA

To Corporations and the Government: get out of my bedroom and stay out of it.
Karen Duncan, Los Altos, CA

I will boycott Hobby Lobby and any other business that sticks their nose and religion in their employees’ business because that is also MY BUSINESS.
Beverly LaClair, Newport, MN

To the Justices of the Supreme court of the United States,
For god’s sake, do not allow the churches, synagogues and mosques in this country to dictate the law of the land. If the religious objection to contraception is the goal, let them preach to their own. If the health and welfare of all of the citizens of the United States is at issue, the court must rule in our favor. Let women and their husbands and physicians have the right to accept or reject birth control and abortion. It is a right of every citizen to decide. And it is your job to protect that right.
Ida Luckower, White Plains, NY

To the Supreme Court: If you are going to limit a woman’s right to health care insurance that will not cover birth control and abortions, then I suggest you consider legislation that would make vasectomies mandatory. Don’t you think it’s time for men to step up to the plate and take full responsibility for birth control and unwanted pregnancies? That way, you wouldn’t have to consider all this legislation around a woman’s right to choose.
Alyse Ceirante, San Francisco, CA

I have my fingers crossed that the Supreme Court will do the right thing for a change!!!!
Larry Griffin, San Francisco, CA

Thank you for speaking out!

You can add your voice and support our video project to protest the extreme Mad Hatter right wing. http://bit.ly/1rj87VY

Please support our work:




Extreme Right Wing = Mad Hatter’s Tea Party ???

Does the extreme right wing sound like the Mad Hatter’s Tea Party from Alice in Wonderland?

Attacks on access to birth control and abortion are out of touch, and off the deep end.

Legislators who are proudly ignorant about women’s anatomy and biology have been having a wild party setting new standards in government intrusion into our bodies.

Had enough?  Take a look at our new 1-minute pilot video to kick start our campaign to call out and push back against the extreme right wing, and to ramp up effective support for women’s reproductive health, rights, and justice.

This week, the Supreme Court heard from two corporations that claim they have a legal right to exclude 4 kinds of birth control from their employees’ health insurance coverage.  They claim they have this right because corporations have a religious conscience, a novel claim.

The Court is expected to take a “straw poll” vote on their verdict this week.

Public opinion matters.  Across the country, we’re speaking out.  See what some supporters who have had enough are saying (below).

This is insane!  These are businesses – not churches.  They have no business butting into their employees’ medical decisions!   M.L. Jones, Indianapolis, IN

Corporations have consciences?  Eggs are people?  But women are apparently not people with consciences who can be trusted to act responsibly.    Claire Wendland, Madison, WI

What is it going to take to make you get the clue that you have no damn business at all in making women’s personal medical decisions?    Jessica Kraskian, Park Ridge, NJ

Really!    Charlotte Taft, Glorieta, NM

Having lived when few birth control options were available I find it outrageous that men (mostly) still want to control women and their bodies…it is not theirs, it is ours…                          Marie Delloue, San Francisco, CA

Practicing one’s religion is all well and good, but enforcing those beliefs on others is wrong. The Bible doesn’t instruct us to force our beliefs on others, rather it teaches respect of the beliefs of others.    Hank Stevens, Gresham, OR

The Christian Taliban has no right to determine how women protect their own health.    Dianne Marsella, Aurora, IL

My body belongs to me.    Dolores Dempsey, San Diego, CA

Dear Supreme Court Justices,
Please uphold the Affordable Care Act by supporting a woman’s right to affordable birth control.  Thank You.        
Carol Garvey, San Jose, CA

Thank you Trust Women Campaign for keeping us informed on what our opponents are manipulating each and every day. Roma Guy, San Francisco, CA

Thank you for speaking out!

Please add your voice and contribute to support our video project to protest the extreme Mad Hatter right wing.





Speaking Out to Protect Our Right to Effective Birth Control!

Yesterday the Supreme Court heard from two corporations that claim they have a legal right to exclude 4 kinds of birth control from their employees’ health insurance coverage, based on the owners’ religious beliefs.

Public opinion matters. Now.

The justices plan to meet privately later this week to cast a straw vote on the outcome.

One member of the court will be assigned to write the final opinion, after weeks of closed-door deliberations.  A decision is expected in late June.  Justice Kennedy is expected to play a key role in the sharply divided court.

These cases are dangerous attacks on your rights to effective birth control.

Here’s a sample of what the Supreme Court justices had to say:

Chief Justice John Roberts said that Hobby Lobby and Conestoga, the corporations challenging the requirement, believed that emergency contraception was a form of abortion.  (Trust Women/Silver Ribbon Campaign blogs have debunked this fake science.)

“There is not a single case which says that a for-profit enterprise cannot make a freedom-of-religion claim,” said Justice Antonin Scalia.

Chief Justice Roberts suggested he was thinking of a narrow ruling allowing closely held companies like Hobby Lobby Stores Inc. to claim a religious exemption.

The court’s three female justices dominated the questioning during the first half of the session. Congress, said Justice Elena Kagan, made a determination that health plans must include coverage for a range of preventative care for women. When employers seek to deny that coverage on religious grounds, women are “quite tangibly harmed.”

Justice Anthony Kennedy asked, “Under the challengers’ arguments, do employer rights trump those of workers?”

Stop the Mad Hatter’s Tea Party! Protect contraception!

Join these supporters and sign the petition to tell the Supreme Court that the extremists who are attempting to hijack your right to effective birth control appall you.  Here’s a sample of what the American people have to say:

 Fake science??  You bet.    

Becky Mock, Burlington, NC

 

Corporations do not have a conscience. They are NOT alive. Thus, they do not have a religion. If people don’t like birth control, they don’t have to use it. Employers should NOT have the right to impose their religion on their employees.

Sophia Yen, MD MPH, Los Altos, CA

 

As an OB/Gyn physician, I see women who benefit from all types of contraceptives, both for pregnancy prevention and because of beneficial non-contraceptive side effects.  A woman’s employer has no business interfering in my ability to counsel and treat each woman according to her individual needs.

Jenny Robinson, Baltimore, MD

 

I fought this same battle 35 years ago when I needed birth control and could still reproduce. I don’t want to fight it again even though I can no longer have babies. It is still a woman’s choice to do with her body what she deems the right thing for her at the time.

Pam Smith, Allentown, PA   

 

This is a horrible abuse of power by the right wing. What happened to separation of church and state.  I am a Christian but do not want religion in my government. Current abuses are horrendous but this attempt is really against the best interests of the constitution of the US.  Please do not allow this to proceed. 

Cheryl Traverse, San Francisco, CA

 

The “religious freedom” argument behind the suit is, preposterous, as today’s NY Times points out.  Don’t fall for it!                                              

Ben Neufeld, Los Angeles, CA

 

Contraception is a critical part of women’s overall health and should be universally available.  Lisa LeRoy, Newton, MA

 

Access to birth control is not a corporate decision.

Laura Powell, Easton, MD

 

Trust women to make the best decisions for their health.  Employers have no right to discriminate among legal medications!

Robin Roth, San Francisco, CA

 

Get out of women’s personal lives.  How dare you try to save money by denying this.  I wonder do you still pay for Viagra, penis pumps, Cialis, hair restorer, etc. for men? Talk about greedy discrimination. I used to drive a long way to shop at Hobby Lobby. Not ever again.

Jean Taylor, Navarre, OH

 

Thank you to all who have signed the petition. Your words are heard and we appreciate your support in sharing your message and this petition with your friends and family.

 

The more people that know about this, the greater our impact will be.

 

We will be sharing more of our supporter’s messages as the week goes by, on Facebook, Google+ and Twitter. Be sure to submit your own and check back in to see if it has been posted.

 

 

 

How Does Emergency Contraception Work?

Emergency Contraception: Controversies and Advocacy
The Fight for Fair and Science-based Regulation
Sarah Michelsen, Lisa Kernan Social Justice Fellow, and Ellen R. Shaffer, Co-Director,
Trust Women/ Silver Ribbon Campaign, a project of The Center for Policy Analysis

Transcribed from Sarah Michelsen’s Power Point presentation, San Francisco, July, 2013
What is Emergency Contraception?
Myths and Facts
What is Emergency Contraception?
A safe and effective birth control method used after unprotected sex to prevent pregnancy
If regular birth control was used incorrectly or fails, or after sex without birth control
“Morning-after” pill
Recommended for use after a more reliable method fails, or is not used

 

How Does Progestin-Only Emergency Contraception Work?
Progestin-only EC works by preventing ovulation (the egg cell leaving the ovary).
It used to be thought that progestin-only EC could also prevent fertilization (the sperm and egg joining) or the implantation of a fertilized egg (blastocyst) after ovulation, but that has now been debunked.
The newest studies show the progestin-only EC is only effective before ovulation-if an egg is already present in the fallopian tube, EC will not be effective.

 


Myths and Facts about Progestin-Only Forms of EC
Myth: Progestin-only forms of EC, including Plan-B One Step and Next Choice, can cause abortions.
Fact: Progestin-only forms of EC work by preventing ovulation. They have no effect on a fertilized blastocyst before or after implantation.
Myth: Progestin-only forms of EC will cause birth defects or otherwise harm an embryo if the woman is already pregnant.
Fact: Progestin-only forms of EC have no negative effects on developing embryos, either before or after implantation.

Other Types of EC
Combined progestin and estrogen pill –rarely used
Ulipristal acetate pill
Copper IUD
Combined Progestin and Estrogen Pills
The same as regular birth control pills, in a larger dose.
None currently marketed as EC, although several brands of regular birth control have been approved by the U.S. Food and Drug Administration (FDA) for use as EC.
Women in rural areas or situations where they cannot access regular EC may take larger doses of their regular birth control pills to act as EC, but this is not as effective as a progestin-only form of EC.

Ulipristal Acetate Pills
Marketed in the US as Ella
Available by prescription only, for women of all ages
Significantly more effective than other methods at preventing ovulation, especially between 72 and 120 hours.
May have some post-ovulation effect, including possibly preventing implantation after fertilization has occurred.
Not an abortifacient-does not meet medical definition of an abortion,which is interrupting an established pregnancy, after a fertilized blastocyst is successfully implanted in the uterus.

Copper IUD
Intrauterine Device
Must be prescribed and insderted by a doctor or other trained clinician
Reduces the risk of getting pregnantby more than 99%
Can be effectively inserted up to 5 days after unprotected sex
Can keep it in place for up to 10 years.

Opposition and Barriers to Access

Who is the Opposition to EC? Misleading Quotes
“The secret best kept from the American public is that these drugs can cause abortions. The time for covering up this unpleasant reality is long past.”
“It can irritate the lining of the uterus so that if the first and second actions fail, and the woman does become pregnant, the tiny baby boy or girl will die before he or she can actually attach to the lining of the uterus.”
[NOTE: This is NOT the official AAP –it’s a separate anti-choice rump group.]
“Despite self-reports denying it, ‘ready access’ to EC apparently increases the sexual activity of adolescents which is a risk factor for depression and suicide, poor school performance, more lifetime

Abortifacient Myth
Anti-choice leaders choose to define abortion differently from the medical definition.
The medical definition: interrupting an established pregnancy, after implantation of the fertilized egg [c. 50% of fertilized eggs do not implant].
Anti-choice position: Abortion includes even interrupting the release of the egg into the fallopian tube (ovulation)
Also: Confusion about the mechanisms of action of different forms of EC, and many believe that OTC forms of EC, progestin only pills, cause abortions.
Belief that ulipristal acetate forms of EC cause abortions.
Protecting” Women and Girls
Opponents have painted EC as a dangerous drug, and fanned fears that young girls accessing it without parental notification would lead to promiscuity.
Studies show increased access to EC does not increase promiscuity or reduce use of other contraceptives.
Scare tactics-US Conference of Catholic Bishops spokesperson said expanding access “undermines parents’ ability to protect their daughters … from the adverse effects of the drug itself.””

Why do Barriers to Accessing EC Matter?
Need for ID is shaming and stigmatizing.
Need to find an open pharmacy, regardless of age.
Precludes immigrant women, young women, or others without ID from purchasing, regardless of age.
Creates a barrier for the trans* community.
Disproportionately affects low income women and women of color.
Confusion among the public and pharmacists about who can and can’t purchase leads to older teens and men being denied their right to purchase EC.
Young women under the age of 15 seeking EC are the most vulnerable, and yet have the highest barriers to purchase.
HIGH COST CAN REMAIN A BARRIER –Insurance should cover

The Long Fight for Fair Access
Over a decade of court battles and politically motivated decisions

The Fight for Fair Access
EC first approved by the FDA in 1999
2004: The non-partisan scientific committee assigned by FDA to review the evidence on safety and effectiveness voted 23 to 4 to approve an application to make EC available over the counter without any age restrictions.
Recommendation supported by 50+ medical/health organizations
2005: FDA commissioner overruled decision of the FDA scientific committee
Unprecedented action
Aug.2005: Dr. Susan Wood resigned as FDA Director of Women’s Health and Assistant Commissioner for Women’s Health in protest political influence over science.

Science Vs. Politics
In 2006 EC was made available OTC for those over 18
In 2009 a court ordered the FDA to review that decision, calling it arbitrary and capricious, and to immediately lower the age to 17. FDA lowered age restriction but did not reconsider making it available to all women OTC.
In 2011 FDA Commissioner announced they were prepared to grant Teva’s application to remove all age restrictions on OTC sale-but this decision was blocked by HHS Secretary Sebelius.
Unprecedented for HHS Sec, to overrule her appointed FDA chief .

The Fight For Fair Access: 2013
April 5, 2013-U.S. District Court Judge Edward Korman ordered the FDA to make Plan B and generics of the two-pill medication available for OTC sale to people of all ages.
April 30 2013-FDA approves Plan B One-Step emergency contraceptive without a prescription for women 15 years of age and older
May 1 2013-Department of Justice files appeal, and moves for a stay pending the appeal.
May 10 2013-Judge Korman refuses to grant the stay

 

Judge Korman Calls Out the Administration
“You made that announcement to sugar-coat this appeal.”
“The bottom line is that it’s not possible to provide the data on 11-and 12-year-olds,” Judge Korman said. “You’re using these 11-and 12-year-olds to place an undue burden on the ability of older women to get this contraceptive.”
“These emergency contraceptives would be among the safest drugs sold over the counter.”
“If this were a voting rights case, you’d be here telling me this was voter suppression,” he said. “You’re disadvantaging poor people, young people, and African Americans. That’s the policy of the Obama administration?”
Victory? And What’s Next?
June 11, 2013-Obama administration announces in a letter to Judge Korman that they will accept court defeat, and no longer pursue an appeal.
June 12-Judge Korman approves administration’s plan to comply.

What Did We Win? The Who What and Where of EC SalesOnce this is all implemented…

The Who What and Where of EC SalesOnce this is all implemented… Product Who Can Purchase, OTC or Prescription Location Point of Sale Restrictions
Plan-B One Step Everyone Retail Shelf none
Next Choice One Dose (and any other generics) Age 17 and Older: OTCUnder 17: Prescription Only Behind Pharmacy Counter must ask pharmacist and show ID
Next Choice, Levonorgestrel Tablets, and other 2-pill generics Age 17 and Older: OTCUnder 17: Prescription Only Behind Pharmacy Counter must ask pharmacist and show ID
Ella and Ulipristal acetate generics Prescription only for all ages Behind Pharmacy Counter Must ask pharmacist to fill prescription

 

 

What Do Advocates Need to Be Aware Of?
Only makes Plan-B One Step available OTC with no age restrictions. Two-pill versions of the drug will still require a prescription if under age 17.
Gives marketing exclusivity to Teva, preventing generic forms from being available OTC for at least 3 years.
Administration says that the re-labeling process will happen “without delay.” Really?

What Should Advocates Do?
Hold the Administration accountable for sticking to their compliance plan in a timely manner
Keep the public informed and pressure the Administration and FDA to continue to make more forms of EC, and other types of birth control, widely available.
Propose ways to keep the cost of EC down, and prevent future marketing exclusivity that create monopolies
Inform the public about the decision and how their access to EC will change, as well as hold the administration accountable for doing the work to educate the public.

 

Works Cited

American College of Pediatricians. “Emergency Contraception Should Not Be Passed out like Candy.” LifeSiteNews. N.p., 4 Dec. 2012. Web. 19 June 2013.

Bapat, Sheila. “Justice Doesn’t Just Happen: Feminist Activists Were Essential to EC Ruling.” RH Reality Check. N.p., 24 Apr. 2013. Web. 19 June 2013.

Boonstra, Heather. “Emergency Contraception: Steps Being Taken to Improve Access.” Emergency Contraception: Steps Being Taken to Improve Access. The GuttmacherReport on Public Policy, Dec. 2012. Web. 19 June 2013.

”Center for Reproductive Rights Reopens Lawsuit Against FDA Restrictions on

Emergency Contraception.” Center for Reproductive Rights. N.p., 8 Feb. 2012. Web. 19 June 2013.

“The Fight for Emergency Contraception: Every Second Counts.” Center for Reproductive Rights. N.p., n.d.Web. 19 June 2013.

Jacobson, Jodi. “Court Orders FDA to Make Emergency Contraception Available Over-the-Counter for All Ages.” RH Reality Check. N.p., 5 Apr. 2013. Web. 19 June 2013.

Jacobson, Jodi. “Judge Approves Administration’s Strategy for EC Over-the-Counter …With Reservations.” RH Reality Check. N.p., 12 June 2013. Web. 19 June 2013.

Works Cited

Jefferson, Erica. “FDA Approves Plan B One-Step Emergency Contraceptive without a Prescription for Women 15 Years of Age and Older.” US Food and Drug Administration. US Food and Drug Administration Press Release, 30 Apr. 2013. Web. 19 June 2013.

Keenan, J. A. “Ulipristal Acetate: Contraceptive or Contragestive?” The Annals Of Pharmacotherapy45.6 (2011): 813-15. Print.

Kempner, Martha. “Http://rhrealitycheck.org/article/2013/06/17/plan-b-becomes-available-to-women-of-all-ages-but-everyone-should-have-a-plan-a/.” RH Reality Check. N.p., 17 June 2013. Web. 19 June 2013.

Mozzanego, Bruno. “Ulipristal Acetate in Emergency Contraception: Mechanism of Action.” Trends in PharmologicalSciences34.4 (2013): n. pag. Print.

Noé, Gabriela, HoracioB. Croxatto, Ana MaríaSalvatierra, VerónicaReyes, Claudio Villarroel, Carla Muñoz, Gabriela Morales, and Anita Retamales. “Contraceptive Efficacy of Emergency Contraception with Levonorgestrelgiven before or after Ovulation.” Contraception84.5 (2011): 486-92. Print.

Trussell, James, PhD, and Elizabeth Raymond, MPH, MD. “Emergency Contraception: A Last Chance to Prevent Unintended Pregnancy.” Princeton University, June 2013. Web. 19 Apr. 2013.

Tumminov. Hamburg. UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK. 4 Apr. 2013. US District Court Eastern District of New York. N.p., 4 Apr. 2013. Web. 19 Apr. 2013.

Works Cited

United States Attorney, Eastern District of New York. “Re : Tummino v. Hamburg , No. 12 -CV -0763 (ERK/VVP).” Letter to Honorable Edward R. Korman. 10 June 2013. N.p., n.d. Web. 19 June 2013.

Wills, Susan E., Esq. “Emergency Contraception -Boon or Bane?” Emergency Contraception -Boon or Bane?United States Conference of Catholic Bishops, n.d. Web. 19 June 2013.

Zaidi, Sidra. “Emergency Contraception and Moral Panic: Dissecting the Newest Misinformation Campaign.” RH RealityCheck. RH Reality Check, 9 Apr. 2013. Web. 19 June 2013.

 

For More Information

Princeton University Office of Population Research

American College of Obstetricians and Gynecologists

TEDxBayArea Women -Sophia Yen -Cutting Edge Adolescent Medicine12/8/10

Department of Health and Human Services, Office of Women’s Health

Food and Drug Administration Birth Control Guide

Guttmacher Institute

 

Trust Women/Silver Ribbon CampaignPO Box 29586San Francisco, CA 94129415-922-6204www.oursilverribbon.org