WASHINGTON—In a decision with far-reaching ramifications for women’s health, the Supreme Court today ruled that the owners of certain for-profit corporations can legally impose their religious views on their employees, denying them access to essential health care.
“The Court has sanctioned discrimination against women,” said Elizabeth Taylor, executive director of the National Health Law Program (NHeLP). “By providing some companies an opt-out of federal law, the court has singled out women’s health and permitted these bosses to impose their beliefs on their employees’ health care—absolutely unacceptable.”
The Court heard challenges brought by Hobby Lobby Stores, Inc., an arts and crafts store, and Conestoga Wood Specialties Corp., a cabinetmaker, both of which claimed that the Affordable Care Act’s (ACA) requirement to offer their employees coverage for birth control violates their religious freedom. The Court ruled that the Religious Freedom Restoration Act (RFRA) applies to the companies, and the ACA’s contraceptive coverage requirement is a substantial burden on their religious beliefs. In doing so, the Court found that the Administration could have chosen other means of ensuring widespread contraceptive coverage. As a result, the ACA infringes upon these owners’ rights and the companies do not have to comply with the ACA’s birth control requirement.
“The ACA was designed to have insurance companies cover essential health benefits, including contraceptives. This is the principle behind quality insurance,” said Taylor. “We should not be parsing out and excluding specific services just because women rely on them and their bosses object to their availability. The result of the Court’s decision means that, either the door is open to other RFRA challenges that could result in similar decisions when applied to services such as immunizations, anti-depressants and blood transfusions, or the Court is twenty years behind science and evidence, and thinks that contraception is not basic health care.”
As outlined in NHeLP’s amicus brief and referenced by Justice Ruth Bader Ginsburg in her dissent, public programs should not be asked to step in for private businesses. Public funding for family planning services, Title X in particular, is a critical safety-net, helping those most in need. It is not designed to absorb the unmet needs of women who already have insurance.
“Women have been fighting for more than 20 years to get access to affordable contraceptives,” said Susan Berke Fogel, NHeLP’s director of reproductive health. “In an unprecedented ruling, the Court upended history by allowing select employers to stand in the way. Bosses must not be allowed to interfere with women’s health—full stop.”
Contraception is part of the established standards of medical care and backed by major medical academies in the U.S. and Western Europe. Contraception is crucial not only in preventing and planning pregnancies, but for women managing chronic diseases—conditions such as diabetes, heart disease and lupus, which disproportionately impact women of color. NHeLP’s groundbreaking report, Health Care Refusals: Undermining Quality Care for Women discusses the public health implications of ideological and political attacks on care. Health coverage decisions should be based on patient need, the gold standard of medical practice.
The Court’s ruling concerns a federal statute, the Religious Freedom Restoration Act, and not state law. As a result, today’s ruling does not affect the protections that women currently hold in states with state laws requiring equitable coverage between men and women.
NHeLP is analyzing the real impact on women and how they will access contraceptives as a result of this decision, and will be releasing a detailed analysis in the coming days.