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Unconscionable

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Shame on Supreme Court Justice Sonia Sotomayor for allowing the Little Sisters of the Poor to continue denying birth control coverage to their employees while the Court considers whether bosses should be able to restrict their women workers' access to contraception. The common-sense answer is: Bosses have a lot of power over their workers, but they shouldn't have that kind of power.

Contraception is basic reproductive health care for women. Basic -- as in life-saving. Unintended pregnancy is a well-known driver of maternal and infant mortality. Women who are able to control the number and spacing of their pregnancies are healthier and, when and if they decide to bear children, so are their kids. Such women are not just physically better off, but psychically as well. There's a lot to be said for being able to trust that your community respects your capacity and your right to plan your own family and make your own health care decisions.

I don't doubt that the individuals who control the Little Sisters of the Poor are entitled to religious freedom. I wish they could recognize that their First Amendment right to practice their own religion doesn't trump women's basic rights. Don't women have a First Amendment right not to have another's religious belief forced on them? What about women's right of privacy, to determine whether and when to use contraception or terminate a pregnancy? What about a woman's right to be free from workplace discrimination?

Why would we even consider subordinating the fundamental rights of half the population to the religious zeal of a few?

Surely it comes as no surprise to bosses, politicians and jurists that birth control is both universally used and wildly popular in this country. About 99 percent of sexually active women, including about 98 percent of sexually active Catholic women, have used contraception at some point. On average, women use birth control for 30 years over their lifetimes. According to a 2012 poll, 67 percent agree that "all workers should be allowed to access health care services regardless of their employers' beliefs." And 56 percent of voters support the Affordable Care Act's requirement that health care plans cover prescription birth control with no deductibles or co-pays.

A 2012 study conducted at Washington University in St. Louis confirmed that the cost of birth control matters -- a lot. In the four-year study, women and teens in St. Louis were able to select the contraceptive method that was best for them at no cost.

As described by Tara Culp-Pressler of ThinkProgress:

Researchers found that when women weren't prohibited by cost, they chose more effective, long-lasting forms of birth control and experienced many fewer unintended pregnancies as a result...


Women of reproductive age currently spend about 68 percent more than men do on out-of-pocket health care costs, partly because of high contraception costs -- for example, a year's supply of oral birth control pills typically costs over $1,200 out of pocket. Nearly one in three U.S. women report they have stopped using their preferred contraceptive method, or used it less consistently and effectively, because they could not afford it.

If the benefits of the Affordable Care Act's requirement that health insurance plans include birth control as basic preventive health care aren't already obvious, consider this: According to the Guttmacher Institute, some 95 percent of unintended pregnancies occur to women who did not use contraception consistently and correctly. Knowing the risk of maternal and infant mortality that accompanies unintended pregnancies, who but fanatics actually want to restrict women's ability to access and use contraceptives consistently and correctly?

Unfortunately, the Affordable Care Act's birth control requirement doesn't apply to all employers. Religious organizations -- those that predominantly serve and employ members of their faith -- are given carte blanche to withhold birth control from their employees' health insurance. The Little Sisters of the Poor wants to use that exemption but doesn't qualify it because it holds itself out to nonbelievers, providing services and employment without regard to their customers' or workers' religious affiliation, traditions or beliefs.

Nonetheless (in a move my organization strenuously opposed) the Department of Health and Human Services created a special rule for religious hospitals, schools and other organizations like the Little Sisters: They don't have to pay a dime for their employees' birth control coverage. Not one dime.

Their insurance carrier must cover birth control without deductibles or co-pays, but a religiously affiliated employer like the Little Sisters can rest easy knowing its money is not being used to protect women's health and lives through access to birth control.

But this special rule isn't enough for the folks who control the Little Sisters of the Poor. It turns out that they don't just want the freedom to practice their religion; they also want the power to impose their religious views on their employees, believers and nonbelievers alike. Including views rejected in practice by the vast majority of their own faith community.

That has nothing to do with morality. It's just unconscionable.