Review: The Supreme Court Contraception Mandate Cases
Posted by on July 25, 2014 - 3:13pm

On March 25, the Supreme Court heard arguments regarding challenges to the contraception mandate of the Affordable Care Act, with a decision expected to come down in late June. Here’s a rundown of the main aspects of this important case:

What is being challenged?

Under the contraception mandate in the Affordable Care Act, employers are required to provide employees with comprehensive health insurance, including a range of contraceptive methods for women. Organizations exempt from this mandate include small employers that are not required to provide any health insurance to employees, religious organizations and organizations with select insurance plans that were grandfathered in. Religiously-affiliated non-profit organizations may request exemptions as well. The main issue being decided is whether for-profit organizations can choose not to cover contraceptive care in health insurance plans based on religious objections. This comes down to the scope of the Religious Freedom Restoration Act of 1993 (RFRA), which currently does not apply to for-profit corporations.

Who is challenging the law?

The cases were brought by two for-profit corporations, that while not religious or religiously-affiliated, claim to operate based on religious principles. The corporations are Hobby Lobby, a craft store chain based in in Oklahoma City and owned by a Christian family, and Conestoga Wood Specialties, a Pennsylvania-based company that makes wood cabinets and is owned by a Mennonite family.

Why is the law being challenged?

The corporations challenging the contraception mandate believe that certain forms of birth control drugs and devices, including the morning after pill and IUDs, are equivalent to abortion because they may prevent embryos from implanting in the uterus. As such, they believe that covering the cost of these forms of contraception makes the them complicit with abortion. The corporations do not oppose all forms of birth control, including condoms, diaphragms, sponges, certain drugs and sterilization.

How is the administration defending the law?

Donald B. Verrilli, Jr., the current solicitor general who is representing the U.S. administration, has stated that the law offering comprehensive contraceptive care to women promotes public health and ensures equal access to healthcare for women. He also emphasized that it should be doctors, not employers, who should decide the best form of contraception for women. Additionally, a brief from the Guttmacher Institute points out that many women cannot afford highly effective forms of birth control, and so upholding the law will reduce unplanned pregnancy and abortions.

What are the potential outcomes and implications of the decision?

There are many ways the decision could go, each with varying repercussions. If the Supreme Court decides the RFRA does not cover for-profit organizations, it will end those organizations’ ability to challenge the contraception mandate based on religious beliefs. The Supreme Court could decide the RFRA does apply to for-profit organizations, but still rule on the side of the administration. This would be a less decisive win for the administration that would likely lead to more challenges. If the Supreme Court rules in favor of Hobby Lobby and Conestoga Wood Specialties, it will impact women’s access to affordable birth control, while opening the door to other religious objections raised by employers, such as hiring gay and lesbian individuals, or offering benefits to same sex spouses.

For more information, see the sources below:

Liptak, Adam. "Supreme Court Hears Cases on Contraception Rule."  The New York Times. 25 March 2014.
Totenberg, Nina. "Supreme Court Justices Divide by Gender in Hobby Lobby Contraception Case." NPR. 25 March 2014.
Fuller, Jaime.  "Here's What You Need to Know About the Hobby Lobby Case." The Washington Post. 24 March 2014.
"Health Care Law's 'Contraception Mandate' Reaches the Supreme Court."  Pew Research: Religion and Public Life Forum. 20 March 2014.

The Right to Contraception Coverage
Posted by on July 1, 2014 - 1:03pm

Yesterday, in a 5-4 decision, the Supreme Court ruled that “requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated a federal law protecting religious freedom.” Justice Samuel A. Alito Jr. conceded that the government does have a “compelling interest in making sure women have access to contraception,” but that there are ways of providing that access without “violating the companies’ religious rights.”

Justice Ginsburg’s dissent put into words what many onlookers felt. Justice Ginsburg stated that requiring contraception coverage is vital to women’s health and reproductive freedom. Furthermore, Justice Ginsburg stated this may invite “for-profit entities to seek religious-based exemptions from regulations they deem offensive to their faiths,” including some medical procedures and drugs, vaccinations, and even blood transfusions—procedures which certain religions denounce. While there is no evidence yet to support this claim that corporations will begin splitting hairs over other medical procedures, it does raise important questions about where the line is drawn between business and religion.

Those who disagree with the Supreme Court decision state that requiring all insurance plans to include coverage for contraception improves not only public health, but also ensures that “women have equal access to health care services.” Therefore, this blow was particularly shocking. If other family-owned corporations follow this ruling, the cost for contraception coverage will likely become a barrier for many women. IUD’s, for instance, can coast more than $1,000 once medical exams, insertion, and follow-up visits are added—and it is likely that this may cost too much for some women to pay without insurance coverage.

While the full repercussions of this decision are not yet clear, it is important to develop protective measures that defend women’s healthcare and their access to a range of contraception options.

Source: The New York Times

Newer Contraceptive Methods Needed Among Developing Countries
Posted by on May 23, 2011 - 8:24am

Seven out of 10 women in Sub-Saharan Africa, South Central Asia and Southeast Asia who want to avoid pregnancy but are not using modern contraceptives report reasons for nonuse that indicate currently available methods do not satisfy their needs, according to new Guttmacher research. The findings suggest that substantially bringing down unintended pregnancy rates in these developing regions will require increased investment in the development of new methods that better address women’s concerns and life circumstances.

The report, Contraceptive Technologies: Responding to Women’s Needs, focuses on the three regions that together account for the majority of women in the developing world with an unmet need for contraception. Overall, 40% of pregnancies in these regions—about 49 million—are unintended. Each year, these pregnancies result in 21 million unplanned births, an equal number of abortions (three-quarters of which are unsafe) and 116,000 maternal deaths.

“The findings make clear that meeting the need for contraception requires not only increased access and counseling, but the development of new methods that better meet women’s needs,” says Jacqueline E Darroch, senior fellow at the Guttmacher Institute and one of the study’s authors.

To gain insight into why so many women in developing countries are not using modern contraceptives, researchers analyzed nationally representative data from Demographic and Health Surveys and other sources. They found that the majority of women with an unmet need for contraception are 25 or older and live in rural areas, and about four in 10 are poor. The reasons women most frequently given for not using a method are concerns about health risks or side effects (23%); infrequent sex (21%); being postpartum or breast-feeding (17%); and opposition from their partners (10%).
The findings shed light on the types of methods that could have the greatest impact on increasing contraceptive use: Developing new contraceptive methods that have negligible side effects, are appropriate for breast-feeding women and could be used on demand has the potential to greatly reduce unmet need for contraception. So would methods that women can use without their partner’s knowledge.

The report shows that overcoming method-related reasons for contraceptive nonuse could reduce unintended pregnancy by as much as 59% in these regions. Unintended births and induced abortions could be reduced by similar proportions, and 70,000 maternal deaths could be prevented. However, the researchers note that new contraceptive methods alone will not overcome all reasons for nonuse. Other causes, including poor access to and quality of contraceptive services must also be addressed.

Currently, 104 million women in Sub-Saharan Africa, South Central Asia and Southeast Asia have an unmet need for modern contraceptive methods because of method-related reasons. Taking into account projected population growth, this number will increase to 161 million in the next four decades if concerns about currently available methods are not addressed. The researchers note that there has been a lack of attention and resources dedicated to contraceptive research and development, and that there is a vital, immediate need to reinvigorate the field.
In addition to long-term work to develop new contraceptive methods, they point out that adaptations to current methods could make them more widely acceptable and easier to use. They conclude that immediate headway toward satisfying unmet need could be made by ensuring that women and couples receive more accurate information about the risk of unintended pregnancy and have greater access to quality counseling and services that offer a range of methods.
The report, Contraceptive Technologies: Responding to Women’s Needs, was funded by a grant from the Bill & Melinda Gates Foundation. The findings and conclusions contained within are those of the authors and do not necessarily reflect positions or policies of the Bill & Melinda Gates Foundation.
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Source:  Guttmacher Institute