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How millions could lose birth control coverage

Obamacare delivered no-cost contraceptive coverage to millions; now, another Supreme Court challenge threatens to take it away

Before the Affordable Care Act (ACA), or Obamacare, consumers were at the whim of insurance companies. Insurers had complete control over who they would insure and what services they would cover.

Something a lot of plans didn’t cover was birth control. My plan was one of them – even though I had pretty comprehensive coverage that cost me $1,400 a month before the ACA. (As a self-employed woman with diabetes, I could be charged more by insurers for all three reasons before the ACA, if they covered me at all.)

But my coverage didn’t include one penny of birth control coverage. Not even when I was taking birth control pills for medical reasons at one point, as many women do.

The ACA changed that, by mandating that every insurance plan must cover all FDA-approved birth control methods with no cost-sharing, such as a co-pay or co-insurance. In 2014, my monthly premium dropped by $900, and I gained birth control coverage with no cost-sharing. As a consumer, I’d call that a big win.

Countless women could lose all that in yet another challenge to the ACA that will be heard by the U.S. Supreme Court in 2016. This will be the second lawsuit going to the Supreme Court over objections to the birth-control mandate, one of numerous challenges filed since the ACA became law.

Women’s access to contraceptive coverage at risk

It’s like the Hobby Lobby case all over again. In 2014, the Supreme Court ruled in Burwell v. Hobby Lobby Stores (and the related Conestoga Wood Specialties v. Burwell) that closely held corporations had the same right to an exemption from the birth control mandate that religious employers, such as churches, have had all along under the ACA.

These for-profit corporations aren’t religious organizations. They’re companies owned by people who think their personal religious beliefs should exempt them from providing employee coverage for certain contraceptives. The Supreme Court agreed, so women who work for companies like Hobby Lobby don’t get to choose the method of birth control they want to use. They’re forced to choose from the methods their employer doesn’t object to – if their employer agrees to cover any contraceptives at all.

After the Hobby Lobby decision, the Obama administration announced a workaround to make sure all women continue to have access to all methods of birth control with no cost sharing, no matter where they work, while respecting others’ religious beliefs. Closely held for-profit companies and non-profit organizations that object to providing contraception coverage must simply sign a document stating that fact, and the coverage will be arranged directly between the insurance company and the consumer. The organization never has to be involved.

Seems like a fair compromise, right? Well, not according to non-profit religious organizations like Little Sisters of the Poor Home for the Aged. They’ve filed suit, claiming that even filling out a form violates their religious freedoms, essentially because they’re “endorsing” the insurance provider’s arrangement with their employee. And the U.S. Supreme Court has agreed to hear their case.

“We’re shaking our heads that anyone would oppose this policy to begin with — and now we’re not even discussing the policy,” says Donna Crane, vice president for policy at NARAL Pro-Choice America. “Now we’re discussing whether an employer who opposes contraception for other people is going to stand in the way of your ability to get birth control simply because he has to send a piece of paper to the health plan or the government.”

Actual religious organizations, like churches and synagogues, are still exempt from providing contraception coverage. But as Crane points out, religiously affiliated organizations like those challenging the birth control mandate employ people of all faiths, or no faith. By forcing everyone who works for their organization to follow their beliefs, these organizations are infringing on the religious freedoms of others.

“To what extent are we going to allow someone else – under the banner of exercising their own freedoms – step in front of yours?” Crane says. “We think that’s not appropriate and it’s not American.”

How far will the anti-Obamacare crusades go?

Companies and organizations that are unwilling to even sign a piece of paper allowing their employees to enjoy the same benefits as all other Americans under the ACA are interfering in the personal health decisions of their employees.

Considering that 99 percent of all American women use birth control at one point in their lives, the birth control mandate is commonsense healthcare policy. The best way to prevent unwanted pregnancies is to make sure birth control is accessible at no cost. It’s also a medical necessity for some women, another type of preventive care.

Crane says the birth control mandate has been “transformational” for American women. For example, more women are now opting for long-acting methods of birth control such as the IUD that were once out of reach financially for many.

“We’re already seeing improvements in women’s ability to use birth control consistently or choose the method they want to use, because they don’t have to worry about the cost,” she says. “But there are still people who want to take this away from women, and one way to stop it from happening is for American women and men to stand up and say ‘absolutely not.’”

You can lift your voice to say it’s time to stop the challenges to the ACA and birth control access, with this petition created by NARAL and Democratic Action.

Whether you use birth control or not, it’s important to stand up for the rights of all Americans to have fair, equal healthcare access under the ACA. Because the next challenge could be to any aspect of the law – by any challenger, religious or otherwise – and when will it end? It will end when the American people and those elected to serve them recognize that Obamacare is the law of the land, and our resources would be far better spent improving it than trying to destroy it.

Amy Lynn Smith is a writer and communications strategist who specializes in healthcare and issue advocacy. She creates empowering, educational content that encourages people to be more engaged in their own health, wellness and decision-making – from the doctor’s office to the ballot box.

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