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Sandra Fluke, Advocate

From the desk of ... Sandra Fluke, Advocate, Repro Health Watch

Risking Women's Health in 50 Different Ways: Anti-Birth Control Advocates Turn to the States

June 7, 2012 | Reproductive Health

Sandra Fluke, Advocate

"With this common sense bill, we can ensure that Arizona women have access to the health services they need and religious institutions have their faith and freedom protected."

With these words, Arizona Governor Jan Brewer signed legislation into law permitting any religiously affiliated employer to deny its employees coverage of any contraception used to prevent pregnancy. Sadly, the Governor's words reflect a wave of anti-contraception state legislation. It is hard to believe we are having this conversation today, the 47th anniversary of Griswold v. Connecticut, the case that decriminalized contraception. And it is hard to know where to begin unpacking the misinformation contained in Gov. Brewer's short quote. Three problems are immediately evident:

1. "Common sense." A law that allows any employer to determine what benefits to provide - irrespective of the insurance company's actual policy - is not common sense. In fact, given insurers' eagerness to provide contraception and other preventive care coverage because it saves money in the long-run, this law is the very opposite of common sense. Common sense would be to focus on meeting a woman's health needs without interference by her employer.

2. - "Access." The Governor claims that this law actually bolsters access to the health services women need because it requires coverage when the contraceptive method is used for other medical reasons. But based on my classmates' experiences at Georgetown University, I know that contraception policies covering only "medical necessities" simply don't work. Why? Because even for women who have qualifying medical needs, they require extra burdensome steps. In a survey of my fellow students, 65% had difficulty getting their contraceptive coverage, including facing accusations that they were lying about their symptoms even when a health care provider certified a qualifying medical necessity like polycystic ovarian syndrome or painful menstrual cramps.

Just as importantly, science shows that timely access to contraceptive services vastly improves maternal and child health. Planning and spacing pregnancy is in fact a medical necessity for healthy women and healthy families. But instead of recognizing this fact, this law divides reproductive health care into pregnancy prevention versus everything else - a dangerous method of restricting access to a critical health care need.

3. - "Protecting institutions' faith and freedom." Religious liberty must protect the freedom of faith of individual people, not of institutions. Religiously affiliated employers such as hospitals and universities often employ people of many different faiths. Religious freedom must ensure that each of these employees is able to make her own choices regarding her personal faith - and her personal health care - without interference from someone else's religion. Asserting an institution's right to interfere to deny healthcare is not the kind of protection our government should be providing. If religiously affiliated organizations choose to become employers in secular industries, they should be required to abide by the same employment laws applicable to everyone else - laws like unemployment insurance, workplace safety regulations, and the Affordable Care Act's contraceptive coverage requirement.

There is a ray of hope on the horizon: if the Supreme Court upholds the Affordable Care Act this month, harmful state laws like Arizona's will not go into effect. The federal regulations issued by the Department of Health and Human Services making preventive care, including contraception, available without copays or deductibles will trump any state law that says otherwise. For this and so many other reasons, we should all be extremely concerned about the impending decision from the Court.

But even if the federal health reform law is upheld and these harmful state laws fall, the political moment we are living through right now is telling - and troubling. Contraception coverage opponents are pushing harmful laws across the country.

In Kansas, the governor has recently signed a bill expanding refusal provisions to allow doctors and hospitals as well as many non-hospital facilities to deny drugs that they believe may cause abortions. The language of the bill may even be broad enough for providers to refuse to provide birth control - and a provider would not be required to refer a patient to a provider who would help her.

In Missouri, the legislature has passed a bill that would allow employers to refuse to provide health coverage for services, including contraception and abortion, that conflict with their religious or moral beliefs.

And North Dakota is putting women's health up for a vote: a ballot measure includes language so broad that potentially anyone - including employers, landlords and medical providers - could refuse to follow any law based on their religious views.

These are not isolated incidents. According to the Guttmacher Institute, 13 states allow some health care providers to refuse to provide services related to contraception and 18 states allow some health care providers to refuse to provide sterilization services.

It's not all bad news. In New Hampshire the Senate appears to have shelved a bill that would have allowed employers with religious objections to refuse to provide coverage of birth control.

And the Colorado Senate rejected a symbolic measure expressing support for the Blunt Amendment, a provision rejected by the U.S. Senate that would have allowed employers and insurers to refuse to cover health care services based on the employer's religious or moral beliefs.

Confronted with these attacks on women's health care access, women, and the men who support them, realize that we must stand up and amplify our voices - not just in Washington but also at home. I firmly believe that speaking out is something millions of women across this country can, and ultimately must, do to protect our sisters today and our daughters tomorrow.

We can and must write to our legislators, call their offices, author letters to the editor, and spread the word about this dangerous wave of legislation. We must also turn out to vote this year and every year. Our legislators must be held accountable, and we have the responsibility to ensure that they are! What's at stake is our health and our rights - and we will be heard.For more information, go to www.ReproHealthWatch.org


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