Bosses and companies control many aspects of people’s lives, from their freedom to travel to their self-expression on social media to – if they’re unlucky – when they can go to the bathroom. Female workers are especially burdened to meet onerous, often conflicting expectations. Now the Trump administration is about to hand bosses even more control over an intimate area of those workers’ lives: their ability to decide if and when to have children.
According to a draft regulation obtained by Vox, the Trump administration is planning a broad rollback of employer contraception coverage requirements implemented by the Affordable Care Act (ACA). While contraceptive coverage is already somewhat circumscribed, it could be about to get much worse. It will take effect as soon as the Office of Budget Management approves the rule change and adds it to the federal register.
Under the ACA, also known as Obamacare, virtually all employer-provided health plans were required to cover a wide range of FDA-approved contraceptive methods at no out-of-pocket cost to the insured as a legitimate part of “preventive care”. There were exemptions for religious institutions like churches. While understandable in the context of passing the ACA, this was an imperfect compromise that left the door open to further erosion of reproductive rights.
And erode they did. In 2014, the supreme court ruled 5-4 that a private, for-profit corporation such as Hobby Lobby was exempt from the birth control coverage requirement, provided the company was “closely held” by overlords with a sincere religious objection. It did not establish a decent protocol for determining a corporation’s sincerity, probably because that would involve using psychic powers to peer into a CEO’s soul.
In addition to upholding the same bad science believed by the already-exempt churches – IUDs and Plan B do not, as some erroneously think, cause abortions, although they can prevent fertilized eggs from implanting in the uterus, which is the same to some people — this decision grossly misinterpreted the right to religious freedom. Which, last I checked, did not include the right to impose one’s religious beliefs on others via financial coercion.
It also blurred the line between religious institutions and private corporations … the latter of which already enjoyed many of the same legal protections as human beings. In her scathing dissent, Justice Ruth Bader Ginsburg wrote that it was a “decision of startling breadth” that represented a “radical” repurposing of the religious exemption that would cause “havoc” and extend yet more rights to corporations that were meant for people only.
She also mentioned a so-called “conscience amendment” to the ACA that had been proposed and voted down by the Senate, which, as Senator Barbara Mikulski observed, would have “put the personal opinion of employers and insurers over the practice of medicine”.
Fortunately, the scope of the Hobby Lobby ruling was somewhat limited, and did not mean an end to contraceptive coverage for these companies’ employees. As Ginsburg wrote, the government would “pick up the tab,” an imperfect accommodation of bratty CEOs that nevertheless preserved coverage. Not so with the GOP’s 2017 drafted rule change.
Essentially a return of the long-dead “conscience amendment”, the rule change would provide broad exemptions to any company or university claiming a religious objection to birth control coverage. (There are no such exemptions for other religiously controversial things like blood transfusions and Viagra; this is purely a discriminatory attack on women’s health.) It would also extend to those great bastions of religious morality: insurance companies.
Companies would no longer be required to notify the government of their objections, and the government would no longer be required to find a workaround. What this means is that any employer or insurance company could soon be able to deny women contraceptive coverage, should they claim a religious objection, and the government would no longer pick up the slack. Expect CEOs across the land to experience conveniently timed religious awakenings.
Given that the majority of insured Americans still get their healthcare through their employers, this could affect the lives of hundreds of thousands of women, not to mention the family members who depend on them.
Contrary to what the health secretary, Tom Price, claims, it’s not easy for everyone to meet their costs of pocket. According to Planned Parenthood, a 2010 survey found that “more than a third of female voters have struggled to afford prescription birth control at some point in their lives, and as a result, used birth control inconsistently”.
A 2016 Reuters survey found that women whose employers obeyed the coverage mandate increased their use of birth control, especially long term, effective methods like IUDs. And more effective methods mean fewer unplanned pregnancies. Which, in turn, means less stress in women’s lives, more financial security, and more bodily autonomy. And hypothetically, fewer abortions … although that will be a moot point if abortion is restricted out of existence.
Of course, the best “workaround” for this problem (and most healthcare problems, for that matter) is to take healthcare out of employers’ and insurers’ greedy hands with a government-funded, Medicare-for-all system. But until that happens, employer coverage of basic preventive care must be protected.
Like so much of the Republican agenda, this rule change represents a dual attack on women’s and workers’ rights by an unholy alliance of aspiring theocrats and exploitative bosses. The ACLU is already planning a lawsuit. Other avenues of resistance include writing your representatives, engaging in street actions and forming unions to demand adequate, non-sexist health benefits.
