The debate over whether employers should be required to provide contraceptives to employees, without patient co-payment, has been a topic of discussion for years. It dates back to at least the 1970s, when the U.S. Senate began to debate the safety of the pill, according to a 2010 article published by PBS.org.
With the recent mandate from President Trump, allowing companies and other institutions to deny contraceptives to their employees on the basis of the employer’s moral and/or religious beliefs, millions of people across the United States, particularly women, have the potential to lose free and easy access to contraceptives, said Vanessa Vought, adviser to the HOPE Peer Educators at Slippery Rock University (SRU).
Prior to Trump’s mandate, under the “Affordable Care Act” (ACA), companies were required to pay for their employees’ access to 18 different types of contraceptives. The ACA, also known as “Obamacare,” enforced this ruling because, prior to it, insurers were allowed to charge high and unregulated premiums, Vought said.
“What Obama did with the Affordable Care Act is he basically set a standard,” Vought explained. “He told insurers, through law, that there are 10 essential health services that all health insurance has to cover. Preventive care was one of them, which birth control falls under.”
Vought, said that in addition to women paying premiums for health coverage, it doesn’t make sense for them to have to pay extra for birth control. Some birth control, such as intrauterine devices (IUDs), can cost upwards of $1,000, which can be difficult for some women to pay for, especially those in low-income families, Vought, who’s in her first year as a health educator at SRU, said.
The Trump Administration said the decision to overrule the mandate from the Obama administration was made because it did not want to require employers, who may have certain moral and/or religious objections, to “go against their conscious behavior.” The mandate from Trump says employers can deny this access to contraception, but that they need to provide a genuine moral or religious belief. Vought said the issue with that is that there is no exact definition of what a religious “entity” is. The company doesn’t necessarily need to be a religious one to deny access to contraception, she said.
“They can just claim a religious conviction,” Vought said. “And they don’t even need to claim a religious conviction, they can just claim a moral conviction. If they are going by the rules they are putting out now, then it could basically be adopted by any company that wants to claim this conviction to essentially save them money.”
As a result of this mandate, Vought said, she predicts there will be a large gap in health coverage. The United States provides contraception through a variety of means, such as government-subsidized programs, like Title IX, which says that “No person in the United States will be denied participation or benefits or will be subject to discrimination under any educational program/activity receiving financial assistance from the Federal Government”, state funding (Medicaid), and a variety of other programs. Vought said that this is an issue because, in order to be eligible for these programs, a person has to fall under a specific government poverty, such as being on welfare.
“Basically, if you make anything above that, you don’t qualify for those programs,” she said. “So if you are a person who has a job, who has insurance, you don’t qualify for those programs. Basically, you just get caught in this sort of gap and have nowhere to turn to help you get birth control.”
Birth control pills, alone, can cost up to $100 a month, Vought explained. Vought said she believes there’s no reason for a person, especially one who has insurance, to have to pay for these costs with their own money.
Senior public health major and HOPE Peer Mentor, Amy Kayser, said it’s important for people to realize women who need access to the pill are not always trying to prevent a pregnancy.
“Birth control also helps regulate a woman’s period, and can even help treat acne breakouts,” Kayser, 20, explained. “There are other health benefits to it besides just preventing pregnancy.”
For institutions like the Catholic Church, where contraceptive use goes against its teachings, Kayser, who’s a Catholic, said she believes free access to the pill should be provided, because of the numerous other health benefits it provides.
“I was raised Catholic, so I understand the church’s argument,” Kayser said. “I think these institutions who have these religious and moral beliefs need to accept that there are other benefits to taking the pill other than just having sex without wanting to get pregnant. I just think these sort of companies need to meet their female employees halfway.”
Vought, a graduate from Texas State University in San Marcos, Texas, where she majored in health education, said she recognizes the church’s argument about contraceptives.
“I emphasize abstinence, but you can’t force people to partake in it,” Vought said. “Our motto here in HOPE is, ‘Abstinence is best, but protection is next.”
Some of Kayser’s coworkers in HOPE don’t feel as strongly about forcing companies to provide free birth control. Fellow HOPE Peer Mentor Carlyn Becker said she doesn’t believe institutions should be required to provide access to free birth control. Although it shouldn’t be mandatory, companies should be strongly encouraged and educated on the risks of not providing these services, said Becker.
“It’s a very sticky situation,” Becker said. “On one end, you don’t want companies to be forced to do something that goes against their personal beliefs, but on the other end birth control can help maintain the overall health of a woman.”
Becker, a public health major as well, said that while she doesn’t think contraception should be a requirement for companies to provide, she believes a lack of contraception increases the number of abortions. A Time Magazine article published online, on Oct. 12, noted a 2014 study in St. Louis that said that when provided with proper information and free birth control, the number of abortions and other unwanted pregnancies in the area dropped significantly. There needs to be proper education and information made available to people, and there should be a decrease in the number of abortions, Becker said.
Victoria Kolarik, a HOPE peer mentor and public health—pre-physician’s assistant major, said she doesn’t believe men, like current U.S. Attorney General Jeff Sessions, should have a say in the issue.
“I understand men make up roughly 70 percent of the government, but Jeff Sessions should not have a say in how I take care of my body,” Kolarik said. “Men do not take the pill for any reason, so why should they decide if I get access to it?”