As it was reported by The New York Times, the United State Supreme Court's June 30 ruling in the Hobby Lobby case stirred up controversy among supporters for religious freedom and advocates for women's rights issues. In a 5-4 opinion, the Court determined that the exemptions permitted under the Affordable Health Care Act for religious and non-profit employers now apply to some for-profit companies. Some special interest groups cry foul worrying that the justice's decision in Burwell v. Hobby Lobby takes a step back in time to when women did not have rights to make reproductive decisions. Other groups that advocate for First Amendment rights to religious freedom hail the justices' ruling as fair and in line with constitutionally protected freedoms. Reports in the news gloss over myriad issues from number of employees to the type of contraceptives, but the underlying point being debated that received little acknowledgement is the cost of reproductive health care and the government's role in providing coverage for all.
Although Hobby Lobby Stores, Inc. saw their name highlighted at the forefront of the issue, there was another for-profit Pennsylvania based company who had just as much to gain in the outcome as any other business. Conestoga Wood Specialties Corporation which is located in Lancaster and employs 950 people also appealed to the U.S. Court of Appeals and saw their case combined with the one from Hobby Lobby. Making their living by building and selling wood cabinets, the Hahn's build are Mennonites who believe that it is against the principles of their faith to pay for their employees to receive certain types of contraceptives. A common misconception from the ruling is that the Green who own Hobby Lobby and the Hahn's opposed any and all contraceptives on the formulary for their employees' insurance plans. In reality, these two for-profit organizations only objection was to Plan B contraceptives such as the morning after pill and intrauterine devices (IUD) that are used for emergency contraception purposes. According to USA TODAY, the Court's June 30 ruling does not prohibit their employees from using their insurance to cover the cost the most common type of contraceptives: birth control pills.
Advocates for women's rights to reproductive health caution that the ruling will be used to justify limiting women's choices to contraceptives and other groups fear that religious groups will use the Burwell v. Hobby Lobby to deny their employees coverage for other medical procedures that go against their religion. As it was reported July 1 by Time Magazine through MSN News, the justices were careful in writing their opinion to avoid that very same possibility as they do not want to revisit the case disguised in a complaint from a religious organization that does not want to pay for one of their employees to receive a life-saving blood transfusion because the employer opposes the procedure due to their faith. While there are other for-profit organizations that oppose insurance companies providing any contraceptives for their employees due to their religious beliefs, the ruling means that they could deny paying for an IUD but they cannot limit their employees access to birth control pills.
What might not be widely known and understood is that the outcome in this case is not going to open the floodgates for companies across the nation to eliminate birth control from their insurance plans. Like it or love it, the Affordable Health Care Act mandates that businesses provide women's preventative health care services of which includes contraceptive methods and counseling. Interestingly enough, the contraceptive that received the most controversy is also the one that women elect to use the least. In a report from the University of Pittsburgh's School of Medicine, researchers found that women who received structured counseling for emergency contraception were more likely to use the IUD after learning that it is more effective than more popular forms of birth control. Just the same, women are unlikely to choose the IUD as their primary method of birth control. As compared to other countries, Mother Jones found that even though the IUD is more effective at preventing unwanted pregnancies with a less than 1% fail rate, only 8.5% of American women use the contraceptive device. Cost is the primary reason cited as to why more women do not use the IUD and chose to use less effective measures such as birth control pills and condoms. With the average price of an IUD running anywhere from $500-$1000, many people chose to go with a less expensive product even if that means increasing the risk of an unplanned pregnancy.
Regardless, it is unlikely that a different outcome in Burwell v. Hobby Lobby is going to increase or decrease the use of IUDs. While the upfront cost is heftier than the average monthly price of about $25 for a 30-pack box of birth control pills, the IUD is a more permanent solution to birth control. A woman who knows that she does not want a child for at least ten or more years would benefit from the IUD while a person who intends to start a family in a few years would be better off looking into other types of birth control. What the case does bring to light is that health care is expensive and that employers can decide what their insurance plans will cover or not which the employee may agree or disagree. Prior to this case, many private employers did not cover any birth control products other than "the pill" or sterilization, but they would pay for the cost of a woman to see an obstetrician and for the birth of a child. The advent of the Affordable Health Care Act was sold to the American public as an inexpensive way for every person to have access to health care services when in reality the law only led to confusion, exclusions, court-rulings, and more government intrusion without what was initially promised at least not at a low cost.