The sad consequence of Hobby Lobby’s religious exemption
The political and legal fallout of the Supreme Court’s decision to allow for-profit companies to exempt birth control in their employee health coverage will be measured in the coming years.
But for the employees of Hobby Lobby, and about 50 other companies that have filed for similar religious exemptions, it amounts to a “tax on women and families,” said Dr. Susan Rubin, assistant professor of family and social medicine at Albert Einstein College of Medicine.
The biggest worry for Rubin, who is also a practicing family physician at Montefiore Medical Center in the Bronx, focuses on the same thing that, ironically, religious groups want to foster.
“This additional cost burden, I fear, is going to result in additional unintended pregnancies,” she said.
Birth control is not cheap, from the doctor visits required to prescribe it to the drugs themselves. Women still make less than their male counterparts in most industries, and this additional cost burden is being borne by the very people already unlikely to afford it.
“These people are [probably] not making much more than minimum wage, and it’s a lot of additional cost if you’re making the average salary for retail employees,” Rubin said.
Women, and men whose partners are covered under their insurance policies, will now essentially have to pay twice to get medication that is used in some form near universally. “Families want to use contraception — 99 percent of heterosexually active females have used contraception and may stop using for a number of reasons, one of them being cost.”
Moreover, many women have medical conditions that limit which methods of contraception they can use, or risk developing complications. But without insurance coverage, those options may be priced out of their reach.
Choosing to continue an unintended pregnancy is “not the way to have a family-friendly policy in this country,” Rubin said. And if a woman chooses not to have a child, then she faces significant hurdles in many states with abortions becoming less and less accessible. “We’re cutting abortion access and we’re cutting contraception access — so what’s the end result?”
Beyond preventing pregnancy, birth control drugs have non-contraceptive benefits for women, including relief from painful periods, heavy bleeding, fibroids, clotting disorders and more. But these drugs have a role in ensuring a healthy pregnancy, too.
“Many women with medical conditions may need to take medications that could potentially be dangerous during a pregnancy, and in order to have healthy pregnancies need to have them very well planned,” Rubin said.
From a corporate perspective, the bottom line would logically be that healthy employees mean a healthier profit margin. Which is why Rubin questioned where Hobby Lobby’s priorities are in seeking an exemption that stands to complicate the wellbeing of its workers. Fewer unintended pregnancies mean fewer days off work, and a physically and mentally healthier workforce.
“You want to keep your workforce healthy, and a healthy woman, a healthy family is a planned family,” Rubin said.
Losing medical coverage on religious grounds was not a foreseeable outcome for Hobby Lobby’s workers. An organization such as a church-owned company could expect to draw its employees from a pool of like-minded candidates about its stance on sex and family planning, Rubin noted. But this case was about a for-profit company imposing its owners’ religious beliefs on all its employees, who likely hold a wide range of beliefs.
By limiting its scope to contraception coverage, this decision was neither business-friendly nor pro-religious freedom, as faith-based objections exist to other medical procedures such as blood transfusions and vaccines. “[The justices] explicitly stated that this ruling only applies to contraception — that speaks to this not being a religious issue, but a sex and contraception issue,” Rubin said. “It is shocking that this is going on in the United States in 2014.”
Priced out of care
Here are the costs for some common contraception options, according to Planned Parenthood. Many methods also require a physician’s visit. To find out which is right for you, consult your physician or visit www.plannedparenthood.org and take a short survey.
Birth control pill: $15-$50 (monthly)
Ortho Evra patch: $15-$80 (monthly)
Depo-Provera shot: $35-$100 (3 months)
Implant: $400-$800 (3 years)
IUD: $500-$1,000 (up to 12 years)
Morning-after pill (Plan B): $30-$65