Still not sure what's going on between the Supreme Court, Hobby Lobby, and your birth control? Here's a primer: This week, arguments were made before the Supreme Court regarding the Affordable Care Act's birth control mandate (that all company health insurance plans cover all FDA-approved methods of contraception at no cost). The government has already made exceptions for religious institutions and religious non-profits. Now, two for-profit corporationsÃ¢â‚¬”Hobby Lobby Stores Inc. and Conestoga Wood Specialties Corp.Ã¢â‚¬”are seeking exemptions, too.
Both corporations are family-owned companies with Christian owners who object to certain forms of birth controlÃ¢â‚¬”namely, the IUD and emergency contraception, which they believe to be abortifacients. They're hoping for an exemption under the Religious Freedom Restoration Act of 1993 (RFRA), which states that the government shall not substantially burden a person's exercise of religion unless it is the least restrictive way to further a compelling governmental interest. Earlier in March, Secretary of Health and Human Services Kathleen Sebelius said that these for-profit organizations would not be eligible for exemptions based on the religious beliefs of its owners. However, the United States Court of Appeals for the 10th Circuit previously said that corporations have free speech rights under the First Amendment, per the Citizens United ruling in 2010, according to the New York Times. That brings us to this week's Supreme Court hearing, which focused on whether or not a for-profit corporation could be exempt under the RFRA if that company holds the religious beliefs of it's owners.
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The Medications at Stake
First, let's address the birth control methods in question: the IUD and emergency contraception. The company owners believe that both methods prevent a fertilized egg from implanting in the uterus, which they consider to be a form of abortion. In reality, emergency contraception primarily works by delaying ovulation (so that the sperm and egg wouldn't meet in the first placeÃ¢â‚¬”even after you've had sex), says board-certified gynecologist, Mary Jane Minkin M.D. While both types of emergency contraception (Plan B and Ella) note on the packaging that they may also affect implantation, studies have not been able to prove this, says Jessica Arons, president and CEO of the Reproductive Health Technologies Project.
On the other hand, the IUD primarily works by inhibiting sperm from reaching the egg to fertilize it, says Minkin. However, we do know there are times when an IUD is inserted after you've recently had sex that it could affect implantation, though this isn't how it works on a regular basis. Either way, medical experts confirm that these medications are not the same thing as abortion.
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What Happens Next
During Tuesday's hearing, Justices struggled with several very complicated questions: Can a for-profit company have a religion? Can a company owner refuse to provide health insurance coverage for medications based on their beliefs? If these company owners do get an exemption, how many other company owners would want the exception for their businesses, too? Could employers only oppose certain birth control methods, or could they also object to the company-provided insurance from covering other medical costs like vaccinations or blood transfusions if those procedures or medications go against their beliefs, as well?
"It's hard to predict how they might render the decision and how broad it will be," says Arons. "It may really depend on where the person works and be up to the whim of the employers, with no requirement for that to be based on actual science or evidence." If the Supreme Court rules that these companies do not have to provide insurance that covers all forms of birth control, it's likely that other companies can come forward and ask to be exempt, says Arons. In that case, it isn't just women who work for Hobby Lobby and Conestoga Wood Specialties that need to be concernedÃ¢â‚¬”any woman may encounter this issue. When birth control is not covered by health insurance, it can cost well over $100 a month in some cases. A ruling on these consolidated cases is expected sometime this summer.
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