As National Debate Flares, Surveying Contraceptive Coverage In the States


In the furor surrounding the Obama Administration’s decision this month that contraceptive coverage be provided to women by their employer or insurer, the leadership provided by states in the debate about women’s health has often been overlooked. States have been on the forefront of the fight to ensure that women have access to contraceptives, with 28 states having laws on the books requiring access.

Massachusetts is included in the 28 states where women have access to contraceptives. While Mitt Romney was Governor, he signed an overhaul to the Massachusetts health care system which included a similar contraceptive mandate that required health insurers to provide contraception in the same way they cover other prescription drugs. Although then-Gov. Romney threatened to cut other health insurance options, he never threatened to do the same with contraception.

Of the 28 states that require contraceptive coverage, 8 statesColorado, Georgia, Iowa, Montana, New Hampshire, Vermont, Washington, and Wisconsin — have no exemptions for an employer’s religious affiliation. In New York, Arizona, California, and Rhode Island, the only religious employers who do not have to provide contraceptive coverage are those that employ mostly members of their own faith. All other organizations — such as hospitals, large religious organizations, and universities — must provide contraceptive coverage.

In Texas and Virginia, the employer must be offered the option to include contraceptive coverage in their employees’ health plans, but the ultimate decision on coverage rests with the employer. Even in those states, many religiously affiliated employers do offer birth control as part of their health care plans. As a Jesuit employer that employs many Virginians, Georgetown University offers access to contraceptives free of cost as part of their health plans.

In the Administration’s first proposal that drew controversy, all employers except for churches would have had to provide contraceptive coverage as part of their employees’ health care plans. Catholic and other religious employers were against the rule, saying that it violated their religious freedom. In response, the Administration amended the rules so that religious employers need not directly provide contraceptive coverage, but insurance companies would need to reach out to each individual woman to provide contraception coverage free of cost.

Even before the compromise, the majority of Americans agreed with the Administration’s position. Approximately 56% of all Americans and 53% of all Catholics supported employers offering contraceptives in their employees’ health plans. This overwhelming support of birth control is unsurprising given its substantial use, as even 99% of Catholic women who had ever been sexually active have reported using birth control.

In agreeing with the President’s compromise, several influential Catholic leaders emphasized how it would allow them to provide care without compromising their values. Sister Carol Feehan, president of the Catholic Health Association, the largest network of nonprofit hospitals in the U.S., applauded the change, saying the resolution “protects the religious liberty and conscience rights of Catholic institutions.” A few Catholic organizations were unsatisfied with the Administration’s latest decision. The New York archbishop, Timothy Dolan, head of the U.S. Conference of Catholic Bishops, wrote in a letter to other bishops that “the violation of our freedom of religion [still has not] been addressed” by the Administration’s plan. In the Archbishop’s home state of New York, only religious organizations that mostly employ members of their own faith are exempt from having to provide contraceptives.

The battle for women’s health care and contraceptive coverage will fight on in state legislatures. Missouri, which does require contraceptive coverage allowing insurers to opt out for moral reasons, is bringing forward a bill that would allow any employer to refuse to provide health insurance coverage for contraceptives if it goes against the employer’s religious beliefs. State legislators will clearly have important roles to play in the fight ahead to ensure that women have access to reproductive health services.



Full Resources from this Article

As National Debate Flares, Surveying Contraceptive Coverage In the States


Guttmacher Insitute — State Policies in Brief: Insurance Coverage of Contraceptives

This article is part of PSN's email newsletter, The Stateside Dispatch.
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