Question

Can Employers legally eliminate birth control from healthcare coverage?

The Supreme Court of the United States is taking up this issue this session, and it will be among the first-ever cases heard remotely due to the current pandemic.  

What is the issue presented to the Supreme Court in this matter?

What rule will the court need to apply to decide it?

What are the best arguments of each side?

Which do you find most persuasive, and why?

Do you expect different Supreme Court Justices to approach this differently? How will that matter?

What do you expect the outcome will be, and why?

Do you expect the outcome to be fair and just?

Answer 1

Contraceptive mandate.

A contraceptive mandate is a government regulation or law that requires health insurers, or employers that provide their employees with health insurance, to cover some contraceptive costs in their health insurance plans. Only women's birth control is covered. Health insurance companies do not have to pay for male birth control, such as condoms and vasectomies. In some states, Medicaid provides family planning services and supplies to eligible men and women under the state plan.

In 1965, the Supreme Court ruled in Griswold v. Connecticut that it was unconstitutional for the government to prohibit married couples from using birth control. The Supreme Court agreed on Friday to decide whether the Trump administration may allow employers to limit women’s access to free birth control under the Affordable Care Act. The case returns the court to a key battleground in the culture wars, but one in which successive administrations have switched sides. In the Obama years, the court heard two cases on whether religious groups could refuse to comply with regulations requiring contraceptive coverage. The new case presents the opposite question: Can the Trump administration allow all sorts of employers with religious or moral objections to contraception to opt out of the coverage requirement?

Brigitte Amiri, a lawyer with the American Civil Liberties Union’s Reproductive Freedom Project, said the Trump administration’s approach was unlawful. Allowing employers and universities to use their religious beliefs to block employees’ and students’ birth-control coverage isn’t religious liberty — it’s discrimination,” she said in a statement. “The Trump administration’s attempt to take away people’s insurance coverage for contraception is one of the administration’s many attacks on access to abortion and contraception.”Marjorie Dannenfelser, the president of the Susan B. Anthony List, an anti-abortion group, said by way of example that the Little Sisters of the Poor, an order of nuns who had intervened in the case, should not be forced to provide coverage at odds with its members’ faith.

The Affordable Care Act and Birth Control Coverage. Under the Affordable Care Act (a.k.a. “Obamacare”), health insurance plans are legally required to cover certain forms of birth control. This means that you have access to free contraceptives, even before you hit your deductible! Plans sold through the health insurance marketplace must cover at least one option for each FDA-approved birth control method without copays or deductibles. These rules apply to all Marketplace plans, so your 2020 plan should cover your preferred birth control method.

As of now, the only available over-the-counter birth control pills are for emergency contraception. You need a doctor's prescription to get birth control pills (either progestin-only pills, combination pills, or extended cycle pills).

When it comes to the issue of religious rights versus no-cost contraception, the only thing the Supreme Court could agree on was not to decide.

In an unsigned opinion issued Monday, the court sent a series of cases back to a raft of federal appeals courts, with instructions for those courts and the parties in the lawsuits to try harder to work things out. "The Court expresses no view on the merits of the cases," the opinion said.

At issue is the extent to which religiously affiliated employers (such as universities or hospitals) need to participate in the requirement under the Affordable Care Act for most employer health plans to provide no-cost contraception for women.

The government made several changes to the rules over the past four years in an attempt to accommodate the religious employers' objections while still ensuring that female employees would get contraceptive coverage.

But dozens of religious nonprofit employers sued anyway, claiming that even the act of notifying the government of their objections (which would, in turn, trigger a requirement for the government to arrange coverage) made them "complicit" in providing a service they see as sinful.

The court's opinion, and an accompanying order on several similar cases that were awaiting a decision on whether the high court would take them up, erased all the lower appeals court rulings, all but one of which had sided with the government.

The opinion and order appeared at first glance to put at risk coverage for contraceptives for tens of thousands of employees of the organizations that filed suit. However, the court made clear that because the employers who have sued have already in effect notified the government of their objections, the government can rely "on this notice, to the extent it considers it necessary, to facilitate the provision of full contraceptive coverage going forward."At the same time, however, the opinion said the government "may not impose taxes or penalties on petitioners for failure to provide the relevant notice."The goal, the justices wrote, is that both sides "should be afforded an opportunity to arrive at an approach going forward that accommodates petitions' religious exercise while at the same time ensuring that women covered by petitioners' health plans 'receive full and equal health coverage, including contraceptive coverage.' "

Both sides in the dispute claimed at least a partial victory.

"From our point of view this is a win for religious liberty," said Mark Rienzi, a senior counsel for the Becket Fund for Religious Liberty, which is representing the Little Sisters of the Poor, one of the groups that sued the government. "The government can find ways to give out contraception without hassling nuns."

But at the same time, said Louise Melling, deputy legal director of the Americans Civil Liberties Union, "the opinion states clearly the need for women to receive full and equal coverage."Contraceptive advocates also pointed to a concurring opinion from Justices Sonia Soto mayor and Ruth Bader Ginsburg that stressed that the decision should not be read as approving coverage strategies that make it harder for women to get the benefits."Requiring standalone contraceptive-only coverage would leave in limbo all of the women now guaranteed seamless preventive-care coverage under the Affordable Care Act," they wrote. "And requiring that women affirmatively opt into such coverage would 'impose precisely the kind of barrier to the delivery of preventive services that Congress sought to eliminate.' "It remains unclear what the lower courts might do. In an effort to break what was clearly a 4-4 deadlock, the court in March asked each side for supplemental material outlining potential compromises. The decision Monday referred to those new briefs as suggesting that providing contraceptive coverage without requiring notice from religious employers "is feasible."But Soto mayor and Ginsburg, in their concurring opinion, noted that "the Courts of Appeals remain free to reach the same conclusion or a different one on each of the questions presented by these cases."

Plans sold through the health insurance marketplace must cover at least one option for each FDA-approved birth control methods for women without copays or deductibles. These rules apply to all Marketplace plans, so your 2019 plan should cover your preferred birth control method.

According to HealthCare.Gov Food and Drug Administration-approved contraceptive methods prescribed by a woman’s doctor are covered. This generally includes:

· Barrier methods (used during intercourse), like diaphragms and sponges

· Hormonal methods, like birth control pills and vaginal rings

· Implanted devices, like intrauterine devices (IUDs)

· Emergency contraception, like Plan B and Ella

· Sterilization procedures

· Patient education and counseling

Plans aren’t required to cover:

· Drugs to induce abortions

· Services related to a man’s reproductive capacity, like vasectomies

What Plans Don’t Have to Cover Birth Control

As of July 2015 all plans, except for the following, must provide at least one method from each of the 18 FDA approved birth control categories at no out-of-pocket costs:

· Religious employer health plans (houses of worship don’t have to provide coverage. For all other religious employers women are provided contraceptive coverage through a third party).

· Grandfathered health plans (plans purchased before March 23, 2010)

· Short Term health insurance

· Alternative plans offered by insurers that specifically exclude some forms of birth control (each exchange is supposed to offer at least one plan that doesn’t provide coverage for controversial contraception).

All non-exempt plans cover basic birth control, but only some specific plans cover all birth control types. The rule is that each of the 18 FDA approved categories has to be covered by at least one drug or service, not that everything related to contraception must be covered. Plans that were “grandfathered in” before the new ACA protections kicked in may be exempt from offering contraception for free. This includes some group health plans. In addition, short term health insurance does not have to provide contraception.

How can I get birth control pills for free? There's a good chance you can get low-cost or free birth control pills if you have health insurance. Because of the Affordable Care Act (aka Obamacare), most insurance plans must cover all methods of birth control at no cost to you, including the pill. They enhanced women's opportunities to control childbearing and their careers, allowed them to choose contraception and plan fertility independently of their partner or spouse, increased female human capital accumulation, labour market options and earnings. Thanks to the ACA's benefit, more than 62 million women now have access to birth control without copays or other out-of-pocket expenses. Even though birth control pills are very safe, using the combination pill can slightly increase your risk of health problems. Complications are rare, but they can be serious. These include heart attack, stroke, blood clots, and liver tumors. In very rare cases, they can lead to death. Even though birth control pills are very safe, using the combination pill can slightly increase your risk of health problems. Complications are rare, but they can be serious. These include heart attack, stroke, blood clots, and liver tumors. In very rare cases, they can lead to death.

The birth control pill (also called "the Pill") is a daily pill that contains hormones to change the way the body works and prevent pregnancy. Hormones are chemical substances that control the functioning of the body's organs. In this case, the hormones in the Pill control the ovaries and the uterus.

Causes of an incorrect test result. Though pregnancy tests are highly accurate, there's still room for error. A few issues can affect your results, but your birth control pill isn't one of them. The hormones in your birth control pill don't affect a test's ability to detect hCG.

Even though birth control pills are very safe, using the combination pill can slightly increase your risk of health problems. Complications are rare, but they can be serious. These include heart attack, stroke, blood clots, and liver tumors. In very rare cases, they can lead to death.

Risks of taking birth control while pregnant

The good news is that birth control has been shown to be safe in early pregnancy. ... If you test positive, you should stop taking your birth control pill. Becoming pregnant while on birth control does increase your risk of ectopic pregnancy.

You could have a false-positive result if you have blood or protein in your pee. Certain drugs, such as tranquilizers, anticonvulsants, hypnotics, and fertility drugs, could cause false-positive results. If you get a negative result, you're probably not pregnant.

The longer a woman takes birth control pills or hormone-replacement therapy, and the higher the dose, the more likely she is to look younger. That's partly because estrogen can increase water retention, helping to smooth out the skin. ... Women who didn't drink looked younger than their twins who did.

In around 10 percent of women, HCG levels only begin to rise the first day after a missed period. In these women, a test is unlikely to be accurate if carried out at this time. Not using the test the proper way or checking the results later than the recommended time can lead to false-positive results.

Hobby Lobby is an arts and crafts company founded by self-made billionaire David Green and owned by the Evangelical Christian Green family with about 21,000 employees. It provided health insurance covering the contraceptives Plan-B and Ella until it dropped its coverage in 2012, the year it filed its lawsuit. In June, the appeals court ruled that Hobby Lobby Stores, Inc. is a person who has religious freedom. ... Two other federal appeals courts ruled against the contraception coverage rule, while another two upheld it. The case was previously titled Sebelius v. Hobby Lobby. The company objected to paying for emergency contraception including Plan B, Ella—both commonly known as the morning after pill—plus two types of IUDs. Hobby Lobby said they believe these types of birth control amount to abortion.

When did birth control pills become legal

It was just five years after the pill was approved for use as a contraceptive in 1960 that birth control became legal nationwide in the U.S. That is why the impact of the pill on the health and lives of women and their families will be forever intertwined with the 1965 U.S. Supreme Court decision in Griswold v. Contraception has health benefits, as the HHS points out, because it can reduce women's cancer risk — combined birth-control pills can lower your risk for ovarian and endometrial cancers, anyway.