Under Coverage

Your Health Care, Your Choices (Amen, to That!)

The contraception mandate rightfully highlights preventative care, including a woman’s right to use her benefits as she so chooses—whether it impedes on a company like Hobby Lobby’s religious beliefs or not.


Arguments start this week for Hobby Lobby v. Sebelius, the Supreme Court case that will determine the fate of the contraception mandate put forth by the Department of Health and Human Services after the Affordable Care Act was passed into law. The contraception mandate is part of a larger mandate by the ACA to classify dozens of medical services, like wellness checks and vaccinations, as “preventive” care, which would then require insurance plans to cover them without a copay. The idea is that this will both make health insurance work better for enrollees and save money overall by encouraging prevention. Contraception was included after the Institute of Medicine recommended it for its well-known effects of preventing unwanted pregnancy, and thereby preventing unplanned child-bearing and abortion.

Hobby Lobby, the arts and crafts retailer based in Oklahoma, and about 100 other companies are now suing over this specific aspect of the prevention mandate, arguing that their religious liberty is violated if women who work for them use their health care plans to cover their contraception. The argument should alarm anyone who has a boss and works for money. After all, your health care plan belongs to you, as your paycheck does. You worked for it and your boss transfers it to you, along with your other benefits and paycheck, as compensation for your work. Hobby Lobby is arguing that even though they signed the plan over to you, they feel they should control how you use your own plan or else your private choices violate their “liberty.” If Hobby Lobby wins, it could open the door to all sorts of alarming infringements on an employee’s right to privacy and religious freedom, by giving their employers a vote in how they use their compensation packages they earned by working.

Conservatives in the media would like you to believe this grotesque power grab by Hobby Lobby and other employers is about religion and accommodating people with sincere religious convictions. But this is, on its surface, a laughable claim, since Hobby Lobby is angling to deprive women of their religious liberty to use their own health care plans as they see fit. The blunt truth of the matter is the right’s motivating factor on this issue is not “religious liberty,” but hostility to contraception. Religion is just the fig leaf draped over what is really an attempt to open up the war on reproductive rights to attacks on contraception access, starting with making what used to be non-controversial—the idea that health insurance should cover common contraception medications—seem like it’s a big controversy. Once that idea is planted, the next move is to start disparaging contraception directly, building up more political support to find new and innovative ways to make it harder for women to get, just as the right made abortion harder to get.

The move in that direction started fairly immediately, with Rush Limbaugh denouncing Sandra Fluke as a “slut” for daring to suggest that health care plans should cover contraception (which, again, most already did). He received a bunch of blowback for that, but the idea that there’s something seedy and sinful about using contraception at all has crept up in conservative rhetoric since then. The most famous recent example is Mike Huckabee making a speech in front of the RNC arguing that the only reason Democrats would support contraception coverage in health care is they believe women “can’t control their libidos.”

But these little hints, suggestions and insinuations in right wing media have nothing on what conservative organizations put in their briefs to the Supreme Court arguing against the contraception mandate. Reading these briefs, it’s hard to deny that a major argument—really, the major argument—is that contraception is inherently evil because it allows people to have sex without procreation, and therefore the government should be making it harder, not easier for women to get.

The American Freedom Law Center’s brief argues that contraception “has indeed harmed women physically, emotionally, morally, and spiritually” and turns a woman into “mere instrument for the satisfaction of [man’s] own desires.” The possibility that women might like sex themselves is generally disregarded in these briefs, which tend to think women only endure sex in order to get men to like them.

A brief filed by various conservative media groups, including Eberle Communications Group, Inc., D&D Unlimited Inc. and Joyce Meyer Ministries, argues, “Female sexual activity without risk of pregnancy is to be encouraged by the contraceptive mandate, not only by making a wide range of contraceptives available, but by an education and counseling program designed to ensure that more and more women do not get pregnant unless ‘at the point of conception’ they want to.” It’s not actually as self-evident as they seem to think that it’s a bad thing if people get to have more frequent and satisfying sex—many people would point out that frequent, satisfying sex is good for your mental health and your relationship—but even if you accept their sex-is-bad premise, their fears are misplaced. An expansive study out of St. Louis that followed the lives of nearly 10,000 women who had access to free contraception showed that it had no impact on their sexual decision-making, and certainly didn’t encourage more sex. Turns out people have sex because they want to, and contraception just makes it safer and healthier, as the IOM first argued.

The Beverly LaHaye Institute was worried that contraception makes it harder for women to get married, writing in their brief, “the documented negative effects the widespread availability of contraceptives has on women’s ability to enter into and maintain desired marital relationships.” The idea is that men are naturally repulsed by women’s personalities and, as men are incapable of loving women, the only way to get a man to marry you is by locking him down with a pregnancy. Or, in some cases, rushing into marriage at a very young age because you’re horny and you have no way to prevent pregnancy if you have sex. How romantic. And incidentally, how utterly untrue! The growth in contraception access has apparently led to a lower divorce rate, probably because people who can have sex without rushing into any decisions make better decisions.

In a rational world, Hobby Lobby’s case wouldn’t have gotten this far—and not because it’s completely unfair for a company to argue that it should control an employee’s compensation package because they disapprove of her personal choices. (Though, really, that should be reason enough.) It’s because we all benefit from a culture where regular contraception use is the norm and women only have babies when they want to. As the IOM argued in its initial recommendations, “Women with unintended pregnancies are more likely to receive delayed or no prenatal care and to smoke, consume alcohol, be depressed, and experience domestic violence during pregnancy,” adding that unplanned pregnancies are more likely to result in “babies being born preterm or at a low birth weight.” Researchers in St. Louis found that free contraception also led, unsurprisingly, to a much lower abortion rate, as well.

And yes, having regular access to contraception makes it easier to have fun, fulfilling sex, for both men and women. This is what aggravates opponents of the contraception mandate, but the aggravation of a bunch of uptight puritans should not be anything to base our government policy on. It’s your health care plan. You paid for it with the sweat of your brow. If you want to use it for a happier, healthier sex life, it’s not anyone else’s business.