As a 79-year-old woman, I grew up in the 1950s before women had access to safe, legal and affordable birth control. I remember well how women were often terrified of a pregnancy that would force them to stop working when they could not afford to do so, or wanted to further their education or their career. Sometimes a pregnancy meant more children than they could care for or afford. I remember the extreme and often illegal measures a woman would take to end an unintended pregnancy, even if it threatened her health or life.
Thankfully times have changed.
Women are now better able to direct their lives and control the timing of when, how many, or if they will have children. The Affordable Care Act recognizes that affordable contraceptive coverage is essential if women are truly to be equal and independent members of our society. It should be noted that an expert panel at the Health and Medicine Division of the National Academies identified contraception as one of eight key preventative health services that should be made more accessible to women. For all these reasons, the ACA requires health insurance plans to include comprehensive contraceptive coverage, without copays or other added costs for the women.
Over the last few weeks, the US Supreme Court accepted additional briefing in the case of Zubik v. Burwell. This case considers whether an accommodation given to religious non-profits that allows them to opt out of the coverage requirement respects the religious freedom of non-profits which object to birth control on religious grounds. One of the objecting non-profits -- and a plaintiff in this case -- is the Little Sisters of the Poor, which operates the Mullen Home for the Aged here in Denver.
Under the accommodation, the employer need only notify its third-party insurer of its religious objections to contraception, or notify the US Department of Health and Human Services, and then it is relieved of the coverage requirement. The third-party insurer must separately provide this benefit directly to the woman without the employer's participation.
The non-profits in this case argue that the opt-out provision violates their rights under the federal Religious Freedom Restoration Act. Eight of nine federal courts of appeals have rejected such a claim, finding that this accommodation is consistent with safeguarding the religious liberty of the objecting non-profits.
Serving as a reminder of just how much courts matter, the US Supreme Court ruling in Zubik may make a woman's ability to access birth control dependent on the religious views of her employer. No employers should be allowed to impose their personal religious views on their workers. Religious liberty means that a worker should be able to make reproductive health care decisions on the basis of her own faith, beliefs and circumstances, no matter where she is employed or the religious beliefs of her employer.
In addition to contraceptive access being a matter of personal decision making -- for each woman to decide for herself -- it is a key component of women's health. It is also a matter of equality. Access to contraception is critical to a woman's equal participation in society. Her access to these services should not depend on her employer's religious beliefs.
For the sake of all of our children and grandchildren, I hope we're not going back to the women's health standards of the 1950s.