Ignoring Birth Control as Health Care

That tiny little thing is why I've been able to avoid a hysterectomy for the past several years.  It also costs $1000.

That tiny little thing is why I’ve been able to avoid a hysterectomy for the past several years. It also costs $1000.

I am oddly prudish about discussing anything female-related and discussing sex. I am way too old to feel this way.  Even discussing these things with my Chosen Tribe, I find myself whispering and looking over my shoulder to make sure no-one else can hear – to their great delight, I can assure you.

Having said all that, after hearing the oral arguments yesterday before the Supreme Court in the Hobby Lobby (“HL”) case, I feel compelled to discuss a few things about my own medical history.  I’m flabbergasted at how often it is overlooked ignored that thousands of women use contraception for medical reasons unrelated to controlling birth.

As anyone who reads this blog knows, I’m a lesbian.  I’m also a lesbian in a long-term, committed relationship.  Obviously one of the benefits of such a life is that neither of us should need to use birth control. However, I have an IUD, one of the most expensive forms of contraception available.  And I have it for medical reasons.

When I was 33, I went to my doctor due to specific and extremely problematic issues I’d been experiencing. An ultrasound and other examinations revealed I had developed polyps in my uterus along with a very rough (I forget the medical term) uterine lining.  The polyps were removed and the lining was scraped. Luckily for me, after the torturous three day wait on the testing, the polyps were benign.  However, my doctor and another agreed that over time, the same things were likely to develop again. I was presented with four options:

(1) Hysterectomy – I was 33, M was a little girl, I was nowhere near ready to say I absolutely for certain didn’t want more children. Plus, that’s an extremely expensive and invasive procedure with other long-term effects.  It was also unnecessary because I had the next three options.

(2) Birth Control Pills – I tried, I did, but I didn’t do well on those at all. Some made me nauseous and others gave me migraines, which then made me literally vomit.  I learned that some women just don’t do well on birth control pills. I was one of them.

(3) Progesterone – you know what makes a woman so exhausted during her first trimester of pregnancy? The progesterone hormone suddenly coursing through her. I was a full time lawyer raising a young daughter. I already fought fatigue.  Living that way perpetually was not a realistic option. By afternoon, my words were practically slurring I was so exhausted.

(4) IUD – Intra-Uterine Device. It keeps the lining of the uterus extremely thin and has very little side effects (actually none that I’ve been able to tell). The problem?  Without insurance, it costs approximately $1000.  Luckily, my insurance covered it or I simply would not have been able to obtain this.  It is a medical necessity for me – unless I want to have a hysterectomy.

I had many thoughts while reading the transcript of yesterday’s Supreme Court arguments (yes, I do that.  I’m a con law nerd to the highest degree).  I’ll list four here.  First, just thank God for female Justices.  They were amazing.  Second, how is it we could be listening to a Supreme Court Justice note that HL is only objecting to three or four birth controls (again, IUDs are two of them) and then ask “that’s not terribly expensive stuff, is it?”  Wow.  Love how informed Justice Scalia is on the facts, not that he generally allows facts to get in his way, of course.  Luckily for my blood pressure, General Verrilli responded that IUDs were the most effective but also most cost-prohibitive forms of contraception.  $1000 is not something I could have even come close to shelling out last year when it was time to have my IUD replaced (which hurts like absolute hell, by the way.  The joys of being a woman.).  Third, a bit of an aside, I appreciated Justice Sotomayor’s reference, albeit briefly, to HL’s hypocrisy in that prior to the ACA, HL’s employee insurance plans actually covered two of the very contraceptives they’re complaining about now. After the ACA requirements went into effect, it specifically changed its insurance plan to exclude those. This resulted in its no longer coming under the ACA’s grandfather clause, which would have allowed it to avoid the requirement of covering the other two contraceptive methods about which they now complain.  Then they brought their lawsuit.

Fourth, and most importantly, I am exceedingly concerned that there was not one single mention during oral arguments that birth control is often used for MEDICAL PURPOSES – the precise reason people have health insurance in the first place. I had a specific medical problem and in order to avoid an unnecessary surgery, I use an IUD – a decision I reached with my doctors after considering various medical options.  It is astounding to me that, depending on the summer’s ruling in this case, a corporate owner’s religious beliefs could trump that decision and force a woman in my situation to have a hysterectomy when an IUD is available and would prevent it.    Frankly, I have a religious objection to that.

Surely we can do better than this absolute nonsense.

There are a dozen more legal issues wrapped up in this case, too many to address here. But I do want to mention that the possibility a corporate owner/shareholder/managing member could assert their religion in order to avoid compliance with federal laws will spell hell for the LGBT community.

As always, predicting a ruling based on oral arguments before the Supremes is a fool’s errand.  So, it’s yet another June wait.


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4 Responses to Ignoring Birth Control as Health Care

  1. Tribe Member says:

    Not only the LGBT community, but women’s healthcare in general. Religious reasons aside, why does it feel like it is women who take the hit when corporations want to rule out this or that medical coverage? I’ve actually heard a corporate executive call pregnancy a “self-inflicted disability”. I know this particular executive happened to be kidding… however, what could happen to women’s healthcare if religion is allowed as a reason to deny coverage to an entire sex? I know this much: it will not be funny. It will not be funny at all.

    It is astounding to me that there are still people in the world (not to mention the workplace) who believe all contraception or contraceptive devices address only the prevention or termination of pregnancies and that the idea somehow makes it okay for them to deny coverage to loyal employees. It is common healthcare for women! That is what they are talking about taking away, because they are so far above it all on their hypocritical high-horses that they can’t see what is actually fair and just.

    I better stop now.


    • Jen says:

      I do so love when you get on a soapbox. 😉 Though that’s mostly because even on the occasions we disagree, you make substantive, rational points. Here though, we are in agreement. Apparently my naiveté survives because I remain amazed we are even, as a nation, having this discussion and yet … *sigh*

  2. Elene Parker says:

    The question here isn’t the merit of birth control, but more so the RFRA law, wherein exemptions may be made on religious grounds. In that light, I believe that business OWNERS – the guys who OWN their business – should not be forced to support plans with contraceptives that constitute post-conception abortions; ie 4 of the 20 pills available. From my reading http://www.pressreader.com/profile/Media_Mentions/bookmarks/birth_control it’s a completely black and white issue

    • Jen says:

      Hi, Elene. Thanks for reading and I appreciate your comment. Unfortunately (or fortunately depending on your view, I guess), it’s not a black and white issue because most of the legal issues here have never been decided before. First, HL is only objecting to four types of birth control (two of which, even under the broadest of medical definitions, the medical community is in full agreement do not constitute an abortifacient. The other two aren’t pills, they’re forms of the IUD.). Second, it’s definitely not a black and white issue whether under the RFRA a corporation (not an individual), under which the shareholders enjoy immunity from personal liability, may assert a religious objection. That specific issue, where you’re dealing with a for-profit non-religious corporation, has never been considered under the RFRA before this case. Third, even if a corporate shareholder has a religious objection to certain contraception as birth control, as with my situation, I literally never use it for that purpose. I’m not remotely unique in that respect. So, an employee in my situation would be denied a medical need based on what exactly? No religious objection even applies. Fourth, under the RFRA, even if the court finds that a corporation can practice religion and that shareholders’ beliefs implicate that, there is still the matter of what standard is used, it isn’t automatic by any means. What standard is used to weigh the governmental interest in the requirement, the burden placed on the alleged religious belief at issue and the harm to third parties (here that’s employees) has never been decided in this context under the RFRA.

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