by Senator Holly J. Mitchell
Republican senators have blocked a potential congressional fix for the Supreme Court’s recent ruling in Burwell v. Hobby Lobby. Although a majority of the Senate voted for the bill, it fell four votes short of the super-majority of 60 needed to advance. Known as the Not My Bosses’ Business Act, the legislation would have prevented for-profit businesses from dropping birth control coverage for their employees.
Fortunately, here in California women are already largely protected from the Hobby Lobby decision thanks to the Women’s Contraceptive Coverage Act introduced by then Assemblymember Robert Hertzberg and passed by the Legislature in 1999. The law requires employer-based health plans that cover prescription drugs to cover a variety of birth control methods and included only a narrow exemption for religious institutions. It was upheld by the State Supreme Court in 2000.
Although the law was one of the first of its kind when originally passed and continues to be the law of the land in California despite the Supreme Court ruling, it needs updating to ensure that women with health insurance have access to the full range of FDA approved methods of contraception without cost-sharing, delays or restrictions. Introduced before the Supreme Court’s restrictive decision, my Contraceptive Coverage Equity Act will, if passed into state law, enact urgently needed protections and access to birth control.
Women – in confidential consultation with their health professional – should make the decisions about their birth control. A woman’s boss or health plan should have no say in this matter.
More than ninety-nine percent of women use birth control at some point in their lives and over half of all pregnancies are unintended. That's why Congress recognized contraception as basic health care for women and required insurance companies to cover the full range of FDA approved methods of contraception without out-of pocket-costs as part of the Affordable Care Act. Nearly thirty million women across the country have benefited from this provision since it went into effect in August of 2012.
However, in the nearly two years since this policy took effect growing divergence in interpretation and implementation has developed. Some health plans enforce “medical management” techniques that maintain significant barriers to a woman’s birth control method of choice. These include requiring a woman to “try” a method before allowing her to obtain a prescription for it and covering some methods at no-cost while charging a co-pay for others. Some plans deny coverage of certain methods altogether, leaving some of the most effective methods such as IUDs and implants out of reach for many.
Women in California need and deserve comprehensive, state-of-the-art contraceptive coverage that ensures timely access to the birth control method that is best for them and their particular reproductive goals and medical needs. Denying access to a birth control method of choice undermines women’s human right to reproductive autonomy and increases the risk of unintended pregnancy.
In 2014 as the highest court in the land and state governments across the country act to strip women of their reproductive rights, putting their health and safety at risk, California should continue to lead the nation in protecting and expanding access to birth control. Doing so is not only equitable for women and good for their families, it is fiscally prudent: every dollar invested in family planning saves between four and nine dollars in costs related to unintended pregnancy.
California can and must resist turning its back on women and turning back the clock on family planning.
Holly J. Mitchell, Chair of the Senate Select Committee on Women and Inequality, is the author of SB 1053, the Contraceptive Coverage Equity Act.