Today, the Supreme Court of the United States issued a much-anticipated decision in the cases of Sebelius v. Hobby Lobby Stores, Inc and Conestoga Wood Specialties Corp. v. Sebelius. The main issue in these cases is whether the Religious Freedom Restoration Act (RFRA) of 1993 allows for-profit companies to deny health insurance coverage of contraceptives on the grounds of religious objection. The court’s decision to allow corporations to deny insurance coverage of contraception has major implications for Black women across the United States.
The 5-4 decision states that closely-held corporations, like those owned by 5 or fewer individuals, cannot be required to provide contraceptive coverage because RFRA requires the government to provide these corporations the same accommodation it already provides non-profit organizations. Rules related to the Affordable Care Act, or ACA, clarify that non-profit religious organizations do not have to offer health insurance coverage for contraception. The Court was sure to clarify that the decision only applies to the contraceptive coverage requirement and does not apply to other preventive health care services like vaccines or blood transfusions. That’s some good news, but the decision will make it harder for women employed at closely-held corporations to access contraception – an important health care product for all women, and Black women in particular.
Recent data show that 83% of Black women between the ages 15-44 of childbearing potential use contraception, while 78% of Black women have used birth control pills at some point in their lives. Additionally, a 2013 poll shows that about 9 in 10 Black people, regardless of their level of church attendance or political affiliations, believe that contraception is basic health care that should be affordable to all. These data confirm what we already know – that the ability to decide if and when to have children and access to contraception are important issues to the Black community.
Too many of our grandmothers, aunts, and sisters didn’t have a choice in their reproduction. It seems that most of us would agree that no employer should be able to deny health insurance coverage for contraception, or any other basic health care like screenings for cancer and sexually-transmitted infections and vaccines for that matter. That’s why young Black women showed up and spoke up on the steps of the Supreme Court in March to say that bosses should not interfere with any woman’s access to health care. Renee Bracey Sherman, reproductive justice activist and member of the Echoing Ida Black women’s writing collective, captured the sentiments of so many across the country.
“This case is not just about two companies and their employees. It’s about the ability for everyone to make their decisions to access the full spectrum of reproductive health care including birth control; whether we need contraception to have safe sex or because we have a medical condition…It is not our place to make personal decisions for someone else. And it is certainly not the place of a boss or a judge to take away that decision by denying health care coverage.”
For Black women, contraception is as much about reproductive autonomy as it is about health. Black women may rely on contraception to treat endometriosis, manage uterine fibroids, and quell PMS symptoms. Many others rely on it simply to prevent or space pregnancy which can be lifesaving for Black women, who are three times more likely to die from pregnancy-related causes than our white counterparts. For us, and so many women across the world, birth control is a matter of health and life. Allowing for-profit employers to deny contraceptive coverage to employees who work hard for their health care coverage makes accessing contraception more difficult and could very well impact the health and well-being of women across the nation.
In 2011, more than half of Black people were covered by private (usually employer-sponsored) health insurance, either through their own employer or that of a family member, and 57 million adult women of all races were covered through employer-sponsored insurance. If the behavior of companies like Hobby Lobby becomes the norm rather than the exception, it could impact contraceptive access for millions of people in the U.S. and have a disproportionate impact on Black women who, with lower income and wealth on average, may not be able to afford to pay for their contraception out-of-pocket.
Because the Court’s decision only applies to closely-held corporations, millions of women will still be able to benefit from the contraceptive coverage requirement and be able to obtain the contraceptive method of their choice. Health insurance plans provided by organizations that are not exempt from ACA’s contraceptive coverage requirement must cover contraceptive counseling, prescriptions, insertion, removal, and any related service. Yet, many are still unfairly denying women’s health insurance claims. Any woman who believes she has been unfairly denied may call the National Women’s Law Center hotline, 1-866-PILL4US.
Furthermore, it is imperative to share information on how women can access contraception at low or no cost when their employer won’t provide health insurance coverage. For example, Planned Parenthood and Title X health centers offer contraception on a sliding-fee scale and tools like Bedsider.org help people find low-cost birth control in their area.
Finally, we must not forget that our vote is our voice. We cannot underestimate the power of our vote, particularly in times when access to basic health care is under attack more than ever before. We must use every opportunity to put people into political office who will expand Medicaid and other options for insurance coverage we need to protect our health.
This disappointing decision sets a bad precedent not only for reproductive health care, but for women’s health care and all preventive services as well. We must speak up to demand coverage for contraception and educate our families, friends, and neighbors on how to access care because our health and lives depend on it.
Elizabeth Dawes Gay, MPH is a health and social justice advocate and member of the Echoing Ida writing collective, a project of Forward Together. She is the founder of Black Women For… and works as a Senior Associate at the Reproductive Health Technologies Project.