On a Stage Set by COVID-19 and Black Lives Matter, the Supreme Court Limits Access to Birth Control
On July 8, the Supreme Court upheld a Trump Administration regulation that allows private employers with moral or religious objections to deny their employees coverage for birth control in their health insurance plans. The 7-2 decision that threatens access to contraception comes in a time when our nation is consumed by COVID-19 and grappling with the intricacies of untethering long-enduring systems of oppression of BIPOC from our systems of social and political governance. Within the context of these generation-defining events, the decision is more consequential and illuminating of the deeper challenges our country faces.
The pandemic has forced many to reckon with the realities of having a healthcare system that is directly tied to employment. It has been long understood by those with chronic health conditions and those living with unstable employment situations that tying health care to employment creates undue challenges to receiving care, but with record-high unemployment amid a global pandemic these realities became clear to many privileged to have not confronted the consequences before.
The Supreme Court’s decision on birth control in Little Sisters of the Poor v. Pennsylvania forces all of us to reckon with the consequences of tying insurance to employment and thus the moral beliefs of one’s employer. In her dissenting opinion, Justice Ginsberg cited the government estimate that between 70,500 and 126,400 people will be denied access to free birth control as a result of this decision.
This loss of free access, for many, will mean the loss of any access to birth control as costs pose a significant barrier to access. According to Planned Parenthood, the birth control pill can cost up to $850 annually while an IUD can cost up to $1300, which, though long lasting, has an initial cost that poses a great barrier to access for those who rely upon birth control.
There are a multitude of noncontraceptive reasons that people who get periods take birth control that are not to prevent pregnancy. Hormonal contraception is prescribed to treat acne, prevent cancers, manage endometriosis, help control menstrual bleeding disorders, etc., and the utilization of this drug for these purposes will no longer be covered by insurance for those whose employers have a religious or moral objection to contraceptives.
The conversation surrounding this Supreme Court decision has often turned to focus on these noncontraceptive uses of the drug to argue for the patients’ right to coverage of contraception. And while this is an important and valid argument, it is one that must not overshadow the significant health benefits of simply having the choice to not get pregnant.
In addition to all of the life-long health consequences carrying a baby to term can have on the body, it is important to note that the United States has the highest rate of maternal mortality of all industrialized countries with a similar number of births. While Italy faces a maternal death rate of 2 out of 100,000 births, the United States faces 17.4 maternal deaths for every 100,000 births.
These statistics only worsen when we look at racial disparities in the United States. We are living in a moment defined by a movement that challenges this country to acknowledge that Black Lives Matter and that fights to dismantle the systems of oppression faced by BIPOC on a daily basis. We would be remiss to not further the conversation around this Supreme Court decision to the inequitable consequences this decision poses for Black people.
Non-Hispanic black people experiencing pregnancy face a maternal mortality rate of 37.1 deaths for every 100,000 births. This is more than double the rate of their non-Hispanic white counterparts at 14.7 deaths per 100,000 births and more than triple that of Hispanic women at 11.8 deaths per 100,000.
These statistics do not surprise those who have been affected by them. But this decision serves as a reminder of the reach of racism in this country and should push us to fight on every front, especially that of reproductive health care, for equitable attention to and respect for Black lives.
Pregnancy and labor pose health risk to people who can get pregnant throughout the world, but in a country with the resources to make leaps and bounds in the sphere of medicine, these statistics are not only unacceptable but indicative of the lack of proper attention reproductive health care itself has received in the United States.
In a time when the pro-choice anthem, “my body, my choice,” has been coopted by people who refuse to wear masks and in a time when millions march in the streets to remind the world that “Black Lives Matter,” it is more important than ever to contextualize this Supreme Court decision preventing access to birth control within the frames of the world in which it was made.
Reproductive health care is health care—and health care is a human right. This Supreme Court Decision challenges that opinion. It places the freedom of religious and moral beliefs above that of the freedom to control one’s own body. This is no new fight in the battle for reproductive rights, but the opposition feels even more confounding and the fight is somehow weightier in the reality that is July 2020.