Years ago, my doctor prescribed oral contraceptives after I was hospitalized from a ruptured ovarian cyst. I had insurance through my employer at the time and paid a modest monthly copay of $10. When we switched insurance plans during an enrollment period, my coverage lapsed and I had to pay out of pocket for the medication. The snafu was quickly resolved but it was important information, a quick glimpse of the kind of expense I’d incur if I didn’t have a job, or the kind of job that would allow me to contact someone without taking time off work or fearing retribution from my employer to resolve the matter. I worked really long hours then, probably about 80 and at busy season, longer. My compensation included health insurance coverage.
I’ve been curious since this preposterous case where Hobby Lobby refused to comply with ACA’s contraceptive mandate was elevated to the nation’s high court (and now with Monday’s devastating decision) – what kind of fringe costs did these employers fear they’d incur from ACA? How does the mathematics of the exemption of health care costs for female employees inform their bottom line? When you consider how low wages are for retail employees, could it possibly be that the argument that ACA’s new rules would be an undue financial burden for a business as large as Hobby Lobbby, wouldn’t hold water? That’s just the cost of doing business, right? The market could figure this out. Yet, when non-profit faith based organizations sought their exemption from ACA’s contraceptive mandate, we witnessed the advent of the religiously sentient corporate entity, wrapped in the body of Hobby Lobby owner, David Green.
ACA was affirmed the law of the land in 2012, but these incremental, tenacious challenges that we’ve witnessed for the past two years – whether it’s congress seeking to repeal it on loop, GOP ruled states refusing Medicaid expansion or challenges of religious liberty of your employer – have been an incredible mix of powerful men seeking to restrict the lives of not only of women, but poor women and poor people.
Maybe this is simply a war on poor women.
Depending on how other closely held private corporations seek to use the Hobby Lobby decision to deprive female employees medically effective contraceptive health care, what we can expect to see is a disproportionate affect on poor women and sadly, poor women of color.
In Ebony, Elizabeth Dawes Gay outlines anticipated impacts the ruling has for black women:
Black women may rely on contraception to treat endometriosis, manage uterine fibroids, and quell PMS symptoms. Many others rely on it simply to prevent or space pregnancy which can be lifesaving for Black women, who are three times more likely to die from pregnancy-related causes than our white counterparts. For us, and so many women across the world, birth control is a matter of health and life. Allowing for-profit employers to deny contraceptive coverage to employees who work hard for their health care coverage makes accessing contraception more difficult and could very well impact the health and well-being of women across the nation.
In 2011, more than half of Black people were covered by private (usually employer-sponsored) health insurance, either through their own employer or that of a family member, and 57 million adult women of all races were covered through employer-sponsored insurance. If the behavior of companies like Hobby Lobby becomes the norm rather than the exception, it could impact contraceptive access for millions of people in the U.S. and have a disproportionate impact on Black women who, with lower income and wealth on average, may not be able to afford to pay for their contraception out-of-pocket.”
In Colorlines, former Feministing editor Miriam Perez reiterates Justice Ginsberg’s concern in her scathing dissent, noting that, “Women of color are more likely to be low-income, and also more likely to work a minimum wage job…. getting an IUD could cost as much as an entire month’s rent working at the minimum wage…Women of color who are already struggling to make ends meet may face increased burdens. That could mean doing things like splitting one pack of pills between two women each month, as Kimberly Inez McGuire reports two Latina women living in South Texas have been doing.”
Irin Carmon also points to an amicus brief from the American College of Obstetricians and Gynecologists that notes, “Lack of insurance coverage deters many women from choosing a high-cost contraceptive, even if that method is best for her health and lifestyle, and may result in her resorting to a method that places her more at risk for medical complications or improper or inconsistent use.” Moreover, the savings for women under the contraceptive coverage mandate from August 2012 yielded “an average of $269 per woman, according to a recent report by the IMS Institute for Healthcare Informatics, or $483 million total in 2013.”
Social conservatives can hide steep their logic in junk science and feign concern over the morality of women sexual autonomy, but they’re erasing the economic and health realities of women of color.
Poor women are burdened with all the economic consequences of sex and barriers to reproductive health and autonomy. The freedom of Christian values is to pay women low wages and shame them for seeking medical coverage that helps them determine their economic futures.
Syreeta McFadden lives, writes, reads in Brooklyn.