With this month’s Little Sisters of the Poor v. Pennsylvania ruling, the Supreme Court gave employers more freedom to claim a moral or religious objection to the Affordable Care Act’s contraceptive mandate—and to deny their employees birth control coverage. On its own, this decision would be dismal news; in our current social and economic context, it’s a disaster.
We are currently facing the worst labor market since the Great Depression, with women experiencing the steepest job losses after not fully recovering from the 2008 recession. The COVID-19 crisis poses serious threats to the health and well-being of workers, who have witnessed historic declines in worker power and union membership in recent decades and cannot afford to lose pay or employer-sponsored health insurance. And those risks are deeply racialized and gendered, as labor inequality always is.
Meanwhile, the economic crisis will increase consolidation of employers, giving workers fewer options and employers more power to define the terms of work in ways that are unfavorable to workers. This Supreme Court decision gives employers one more way to control the lives of their workers and their workers’ families.
As Justice Ruth Bader Ginsburg said in her dissent, “This court leaves women workers to fend for themselves, to seek contraceptive coverage from sources other than their employer’s insurer, and, absent another available source of funding, to pay for contraceptive services out of their own pockets.”
While the ACA considered the links between health and economic security and was designed to close access gaps, conservatives have relentlessly attacked the contraceptive coverage component since the day it was implemented. In recent years, the GOP and Trump administration have also hollowed out the reproductive health safety net, leaving fewer options for affordable, high-quality care just as people need it most.
Those tearing down the ACA and its protections say women can simply go to a clinic funded by Title X—the federal family planning program. Meanwhile, they are the very same people who have been working tirelessly to shrink and ultimately defund Title X. As a result of their efforts, clinics around the country have had to close or reduce hours.
We are in the middle of a once-in-a-century health and economic crisis. More than ever, people want, need, and deserve the ability to control the timing and size of their families and care for their own health. And every worker who has employer-sponsored health insurance should be able to guarantee this level of care to all members of their family covered under their plan.
This decision is a gut punch at the worst possible time. Allowing employers to deny birth control coverage to their workers—particularly in the current environment—is a Handmaid’s Tale horror that should scare us all.