What does birth control have to do with the congressional budget? Not much – unless you're a House Republican. In their latest effort to thwart Obamacare during the recent budget negotiations, several right-wing legislators attempted to tack a so-called "conscience clause" onto the law. The idea, which dates back several years, is to give employers who cite religious objections a way to block their employees from getting contraception covered by their health insurance.
Under the Affordable Care Act, preventative services, which include birth control, must be covered by health plans with no copayment, coinsurance or deductible. Even so, some top GOP leaders, most notably Rep. Paul Ryan (R-Wisconsin), are still demanding restrictions on contraception. As a result, many women's rights advocates are now on high alert.
Reproductive rights organizations argue that birth control is a critical component of preventive health care and should not be restricted for anyone. "Every woman should receive access to care regardless of where she has employment or regardless of where Obamacare is implemented," says Heidi Williamson, senior policy analyst for the Women's Health and Rights program at the Center for American Progress.
Employers with more than 50 workers that provide insurance plans are required to include contraception coverage under the Affordable Care Act. If they refuse, they can face fines of up to $100 a day for each employee. While Obamacare already exempts churches, mosques and other religious institutions from providing coverage for their employees – a concession to right-wing demands – an array of for-profit and non-profit businesses have now filed 77 lawsuits to push the courts to allow any employer to decide whether employees get birth control coverage. In response, 18 women's organizations are currently working to protect access to reproductive healthcare, filing amicus briefs opposing the employers trying to roll back contraception coverage. No court decisions have been made at this time.
Hobby Lobby v. Sebelius – a suit brought by a Christian-owned chain of arts and crafts stores – is one of the most well-known cases on this issue. In July, a district judge granted Hobby Lobby a temporary exemption from a requirement that it enable insurance coverage for morning-after pills, similar emergency birth control methods and intrauterine devices. The U.S. Department of Health and Human Services filed a notice in federal court in September saying it would appeal that decision. On October 22nd, Hobby Lobby's lawyers asked the Supreme Court to take up the lawsuit. This decision could have significant consequences both for women's health and workers protections.
Juana Rosa Cavero, director of the Reproductive Justice Coalition of Los Angeles, feels that giving employers power over their employees' reproductive decisions can have grave social outcomes. "They're basically directing how women can control their fertility," she says. And fertility, she notes, is tied to a host of other issues including education, employment and overcoming poverty.
Terri Burke, executive director of the Texas ACLU, believes that efforts to give employers the power to dictate contraception policy are ultimately about class divisions rather than religious belief. "There's a whole number of things combined in an effort to separate our society into the haves and have-nots," she says. "This is about driving a wedge into the heart of our society."
Though Republicans failed in their efforts to secure a conscience clause during the shutdown negotiations, women's advocates and organizations feel they must remain vigilant. "Even though we know it's not going to pass, it's taking energy out of us and out of our movement in order to issue press statements, give talking points and constantly having to remind people how important birth control and access to reproductive healthcare is," says Cavero. "These attacks are about this constant picking away at the movement to make us jump at these issues instead or working on a proactive agenda."