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The Supreme Court Allows Employers To Opt Out Of Contraception Coverage

AILSA CHANG, HOST:

The U.S. Supreme Court is giving employers broader authority to refuse to include birth control in their employees' health plans if those employers have religious or moral objections. This comes after years of litigation over an Affordable Care Act requirement that most employer health plans cover contraception. Today's decision is a win for the Trump administration. And NPR national correspondent Sarah McCammon covers reproductive rights. She joins us now.

Hey, Sarah.

SARAH MCCAMMON, BYLINE: Hi, Ailsa.

CHANG: All right. So remind us how this litigation got started in the first place, and tell us what this decision says today.

MCCAMON: OK. To step back a little bit, you may remember that prevention was a big part of the Affordable Care Act. So under the ACA, the Obama administration put contraceptive coverage on a list of preventive health services that most health plans have to cover - they have to offer patients - to patients without a copay or deductible. I talked earlier today with Kathleen Sebelius, who was President Obama's Health and Human Services secretary at the time. She said the administration consulted with medical experts and found that, in many cases, a lot of health services for women, including things like screenings for domestic violence as well as contraception, were not being included in many health plans.

So the Obama administration required birth control coverage in most plans. But there was a lot of pushback to that from Roman Catholic groups and other religious groups who oppose contraception. In response, the Obama administration carved out exemptions mostly for houses of worship. But since then, there's been a lot of litigation over how broad those exemptions should be. The Trump administration allowed much broader ones for both moral and religious objections, and that's what this case is about.

CHANG: OK. Got it. So the court essentially is saying that the federal government can allow employers to refuse to provide this coverage for moral or religious reasons. Now, what's been the reaction from opponents of this rule from the Trump administration?

MCCAMON: I asked Sebelius about that, and she said she respects that some employers have strong religious beliefs about this.

KATHLEEN SEBELIUS: But barring their employees from a benefit that they should be entitled to, barring their employees' spouses and their employees' dependent daughters from being in a situation that they can access this benefit I find to be quite troubling. With all due respect to religious freedom, no one is required to use contraception who does not believe in contraception.

MCCAMON: And writing the dissent, Justice Ruth Bader Ginsburg says this policy leaves women to fend for themselves to find contraception. She says birth control is important for women's health and for their ability to chart their own life's course.

CHANG: All right. Well, as we said, this is a victory for the Trump administration. So what are advocates for this policy saying about what it means in real terms going forward?

MCCAMON: Well, they see it as a win for employers who feel, in essence, that doing what Sebelius suggests - offering this coverage to employees, letting them choose whether or not to use it - that that violates their own religious beliefs. Mark Rienzi is president of the Becket Fund for Religious Liberty which represented the Little Sisters of the Poor, which is a Catholic order of nuns that was involved in this case and previous challenges to this rule. He says it's just not that simple.

MARK RIENZI: The Little Sisters are not trying to bar the pharmacy door and stop their employees from going to get something elsewhere. All they're saying is leave me out of it, right? They're just simply saying, let me stand aside. Let me take care of the old poor people. And don't force me to buy something that is against my religion to buy.

CHANG: OK. So who do you think will be most affected by this?

MCCAMON: Well, religious liberty advocates like Rienzi say this means organizations like universities and hospitals can keep doing their work in accordance with their faith. Reproductive rights groups say it's a big expansion of the ability of employers to make decisions affecting their employees' personal lives and health. And it could mean that some women, especially low-income women, struggle to afford the most effective types of birth control.

CHANG: All right. That is NPR's Sarah McCammon.

Thank you, Sarah.

MCCAMON: Thank you. Transcript provided by NPR, Copyright NPR.