Our families can't afford to lose ACA contraception coverage

On March 25, the Supreme Court will hear two legal challenges to the Affordable Care Act’s contraceptive coverage requirement: Sebelius v. Hobby Lobby Stores, Inc. and Conestoga Wood Specialties v. Sebelius. These for-profit businesses are challenging the federal requirement that most employers provide contraceptive coverage as part of their employee health insurance plans, arguing that the requirement violates their religious liberty.

At the heart of the national conversation about these cases are questions about religious freedom and women’s rights; about the merits of contraception; about employer versus employee rights; and about whether corporations are people under the law and, if so, do the corporation’s rights outweigh an individual’s?

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These are, of course, important questions. But something that should not be lost in this debate is the historic achievement of the requirement—codifying contraception as routine preventive care and enabling millions of women access to birth control without co-pays. More than 27 million women have access to affordable contraception through their insurance thanks to this provision.

Something else that should not be lost is that the contraceptive coverage requirement matters to the uninsured as well.

It may seem counterintuitive, but not when you consider the estimated 30 million people who will remain uninsured despite the ACA, or the millions more who will experience gaps in their insurance coverage or will be unable to use their contraceptive coverage because doing so puts them at risk of physical or emotional harm.

These individuals will continue to need and seek contraceptive care, and they will continue to turn to health centers funded by programs like Title X—the nation’s family planning program—that have provided them with high-quality, compassionate, and confidential care for decades.

Hobby Lobby argues that the federal government can achieve its contraceptive access goals through programs like Title X. That’s wholly untrue. Safety-net programs like Title X—already underfunded and overburdened—are not designed to absorb the unmet needs of insured individuals. Title X is designed to support healthcare that can’t be paid for by another source. The Title X statute and regulations contemplate how Title X and third-party payers will work together to pay for care, directing Title X-funded agencies to seek payment from such third-party payers.

Caring for patients—regardless of their payer source, even when there is not one—is the heart and soul of the work performed by NFPRHA’s members and the network of nearly 5,000 health centers they represent. Although the cases before the Supreme Court are specific to employer coverage of contraception, they do have implications for the family planning safety net and its capacity to provide care to those who need it.

A decision by the Supreme Court to uphold the contraceptive coverage requirement is the right thing to do for all women, regardless of their insurance status. The Court should stand with the 99 percent of women who will use contraception at some point in their lives, the millions of women already benefiting from the provision, and the millions of families that need access to contraceptive services to make responsible decisions for their own health and well-being.

Coleman is president and CEO of the National Family Planning & Reproductive Health Association (NFPRHA).

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