Health On the Hill Reproductive Rights

Supreme Court Cases May Leave Many Without Insurance Coverage for Birth Control

Next week, the Supreme Court will hear two cases, Little Sisters of the Poor v. Pennsylvania and Trump v. Pennsylvania, that could significantly limit birth control access in the United States. The Court’s conservative majority may use these cases to allow most employers to claim religious or moral exemptions to providing contraception coverage in their employee health insurance plans.

With more conservative justices on the bench, the Court may go beyond the limited Hobby Lobby ruling and uphold the Trump administration’s more expansive religious exemption rules. If those rules are upheld, many low-income people will be left without access to affordable contraception.

Currently, under the Affordable Care Act (ACA), most insurance plans must cover all types of birth control approved by the Federal Food and Drug Administration without a co-pay. The Court’s decisions in the two Pennsylvania cases may undo that requirement by upholding Trump administration regulations that allow employers to claim religious or moral exemptions to contraception coverage. A federal court struck down those regulations in 2019.

The Supreme Court heard a similar case, Burwell v. Hobby Lobby Stores, in 2014. Then, the Court ruled that under the Religious Freedom Restoration Act, a for-profit company does not have to directly provide birth control coverage for its employees if its owners have a religious objection to contraception. After that ruling, the Obama administration adopted a more indirect approach to guarantee employees access to birth control. If a company had a religious objection to contraception, the government would work with the company’s insurer to establish an alternate plan to provide birth control coverage.

Sources: Vox 4/29/20, 1/4/20; The Hill 4/2/20