Cost and stigma are barriers to health<\/span><\/strong><\/p>\n <\/p>\n Contraception is widely used and recognized as \u201ca fundamental health care service and a basic public health measure.\u00a0 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\u2019s autonomy, professional and educational achievement, and emotional satisfaction and helped extend their life span\u2026 Mandates requiring wider insurance coverage for birth control are associated with more consistent use of contraception.\u201d[1]<\/a><\/p>\n <\/p>\n 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]<\/a><\/p>\n From 2008-2011, the rates of pregnancy, births and abortions all declined steeply in the U.S.\u00a0 \u201cContraceptive use improved during this period, as more women and couples were using highly effective long-acting reversible contraceptive methods, such as the IUD.\u201d [3]<\/a><\/p>\n 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.<\/p>\n 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]<\/a> \u00a0The ACA requirement waiving cost-sharing is essential.<\/p>\n 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<\/a>‘, 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.<\/p>\n The Hobby Lobby owners believe that 4 selected methods of contraception are abortifacients.\u00a0 This is scientifically wrong in 3 cases, and questionable in a fourth.\u00a0\u00a0 Nevertheless, Justice Alito says for the Court, on pp. 37-8:\u00a0 \u201cit is not for us to say that their religious beliefs are mistaken or insubstantial,\u201d as long as they reflect \u201can honest conviction.\u201d<\/p>\n Granting for-profit corporations protection as religious minorities<\/span><\/strong><\/p>\n 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.\u00a0 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.<\/p>\n The Supreme Court decision fundamentally redefines corporations in a manner that privileges the views of business owners over those of other citizens.<\/p>\n 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.\u00a0 The majority decision in Hobby Lobby, however, confounds this definition.\u00a0 It claims that a for-profit corporation can in fact have religious beliefs, because it is no more than an \u201cassociation of a group of people.\u201d<\/p>\n The legal standard developed by an earlier Supreme Court to protect “discrete and insular” religious minorities requires that the \u201cleast restrictive\u201d course of action be taken to comply with a law.<\/p>\n The current decision analyzes the potential harm to Hobby Lobby from complying with the ACA\u2019s contraception mandate strictly in terms of whether or not its religious objection to that law is sufficiently accommodated.\u00a0 The equation essentially asks, is the mandate to move corporate funds from one corporate bank account to an insurance company\u2019s bank account more or less burdensome to the corporation\u2019s preferred religious belief about contraception, compared with, for example, moving some of the corporation\u2019s funds into its payment of taxes, and having the government cover some of the cost of the mandate?<\/p>\n Remember this?<\/p><\/div>\n The Court\u2019s decision does not factor in the impact of the employer\u2019s benefits choices on the vast majority of individuals who are not a corporation, but use contraceptives.<\/p>\n 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.<\/p>\n <\/p>\n <\/p>\n [1]<\/a> Shaffer ER, Sarfaty M, Ash AS. Contraceptive insurance mandates. Med Care. 2012 Jul;50(7):559-61.<\/p>\n<\/div>\n [2]<\/a> 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\/<\/p>\n<\/div>\n [3]<\/a> 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\/<\/p>\n<\/div>\n [4]<\/a> National Survey of Family Growth (Finer and Henshaw, 2006); cited in IOM (Institute of Medicine). 2011. Clinical Preventive Services for Women: Closing the Gaps. <\/em>Washington, DC: The National Academies Press, p. 102.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":" The Supreme Court\u2019s majority decision in the case of Hobby Lobby et al. presents serious threats to women\u2019s rights, to the public\u2019s health and the public order. Efforts to override the decision at the state and federal levels require energetic … Continue reading ![\"\"](\"http:\/\/oursilverribbon.org\/wp-content\/uploads\/ContraceptionAd_RED-TWSR-logo1.jpg\" "\\"ContraceptionAd_RED"){kind=logo}
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