The Femo: Obama’s Contraceptive Compromise

by Sarah Rubin

I started using the Pill during the spring of my senior year of high school. For me, the Pill marked my commencement into responsible college life and adulthood. It was empowering to feel in control of something so important — a declaration of my ability to be organized, protected, and prepared. But it didn’t prove to be so easy.

My regular-dose birth control pill (price: $4 per month) made me feel cripplingly nauseous. I woke up to my usual 6:30 a.m. alarm with a green face, feeling totally unprepared to get ready for school, let alone to actually sit through my class schedule. This situation lasted for a month and a half before my doctor nixed the idea. I was now to take a low-dose contraceptive (price: $60 per month) that hopefully had less severe side effects.

It did. And for my first two years of college, I shelled out $720 a year to stay effectively protected.

But last August, the cost of my monthly birth control dropped from $60 a month to $0 a month under the Affordable Care Act. This provision of the ACA mandates that most insurance plans cover contraceptives without a copayment. As a result, millions of women saw their copayments for birth control disappear.

Religious nonprofit institutions, including Catholic hospitals and universities, view this new mandate as an infringement on their religious freedom; that is, they believe that employers who do not support the use of contraceptives should not have to provide their employees coverage. In the past few years, upwards of 40 lawsuits have been filed against this provision. Critics have cast President Barack Obama as a president “insensitive to religious beliefs” and a proponent of big, intrusive government.

On Feb. 1, Obama announced the administration’s compromise for religious institutions. They can choose to be exempt from this mandate, but their employees who want contraceptive coverage can still obtain it through “stand-alone,” private insurance policies. These private plans will be separate from the “employer package” insurance plan, and enrollees will be covered by both their employer-based and individual policies. As cost and administrative burden to insurance companies could prove to be an issue, the compromise offers insurance companies who provide individual contraceptive coverage plans reduced fees for the newly created health exchanges under a different ACA provision.

To many Americans, including women’s health organizations and advocates, this compromise represents good policymaking. The Obama administration demonstrated a commitment to providing affordable birth control to American women, while appeasing religious groups who felt that their religious rights were being threatened.

However, this praise has been accompanied by criticism from a multitude of sources. Members of the religious community, particularly Catholic bishops, are continuing to lament the ACA’s infringement on their religious freedoms and cite the need for “a bigger buffer between religious charities and any third party arranging contraceptive coverage.” On the other side, journalist Wendy Kaminer notes the danger of the “religious exemptions” that have taken place under the compromise. According to her article, this logic could set an ugly precedent for religious institutions to become exempt from other laws, and allow them to object to hiring homosexual employees due to their religious beliefs, among other things.

I was lucky to be able to stay on the Pill due to a supportive and fortunate family. But for many women, my situation would have impeded them from continuing to use a low-dose pill and could have made the difference between 99.9 percent effective contraception and an unintended pregnancy. Now, with cost removed as a barrier to access, women can afford and obtain adequate contraceptive methods regardless of their employer’s religious beliefs — a compromise that protects both the choice and health of American women.


photo by Sarah C: