Me and my affordable birth control: voices the supreme court must hear

This article was originally published on The Guardian.

The US supreme court justices listened to oral arguments Tuesday on whether business owners could object on religious grounds to the provision of the Affordable Care Act requiring employers to provide health insurance that covers birth control. The tea-leaf readers are suggesting the ruling could depend on three female justices coming outswinging against the mandate and, as usual, a conservative majority –depending on a Kennedy.

But the Hobby Lobby and Conestoga Wood cases also depend on actual women getting actual contraception. So we asked advocates, readers and employers to weigh in. Now it’s your turn to make the oral arguments of the people.

From the outset, some important questions

Sex, drugs and birth control: are the justices listening?

By Heather Wood Rudúlph, a writer whose work has appeared in Cosmopolitan, the Daily Beast and Los Angeles Magazine and the author of Sexy Feminism

Courtney Everette has been on birth control since she was 17. Did it help prevent unwanted pregnancies? Probably. But the reason this Chicago mom has maintained a regimen of estrogen-based hormonal contraceptives for nearly 20 years has more to do with a desire to walk upright without doubling over in pain – and a hope to preserve her fertility.

Everette has endometriosis, a painful condition in which the uterus essentially grows out of bounds, invading spaces of the body where it doesn’t belong, causing severe pain and often infertility. Unless, that is, it’s treated – quite successfully – with hormonal birth control.

Because she has been using hormonal contraceptives, Everette has avoided surgery. Because of these important drugs, she has delivered two children without complications. And, yes, she is able to afford this care through her husband’s insurance plan, one that adheres to the Affordable Care Act’s contraception mandate.

This morning, the US supreme court heard the case of Hobby Lobby and Conestoga Wood Specialties. Will it really consider stories like that of Courtney Everette? Will the justices hear the call, beyond the shouting about religion and Obamacare and equality and discrimination, of so many women for whom the actual contraceptives at the foundation of the cases so desperately matter?

In the chamber today, lawyers representing the male owners of these two for-profit companies just argued that their clients’ religious freedom is being compromised by the new healthcare law because their beliefs hold that certain contraceptives are akin to abortion.

Will they pause to consider the millions of women who rely on hormonal contraceptives to manage medical conditions that range from chronic acne to ovarian tumors?

Are these health concerns moot if a pregnancy is prevented while a woman is taking the contraceptive that may be saving her life?

Does a woman’s pain and suffering somehow become less urgent because the symptoms originate in her reproductive organs?

These are not issues of religion, but of blatant gender and class discrimination. What the court is ultimately deciding here is which of these freedoms is more important: does liberty and justice apply more to the right to accessible and affordable healthcare, or to individuals’ right to enforce a moral code on anyone who has no other choice but to adhere to it – because their job depends on it?

Here are the stories of women whose lives depend on contraception. These are the voices we should have heard in court today.

From women who need their birth control

Members of Planned Parenthood demonstrate outside the supreme court. Photograph: Zuma / Rex

My little $1,200 Obamacare miracle

By Elizabeth Bolton, associate director of art, editorial and media at theAmerican Association of University Women

It took me a long time to realize what was causing my severe acne. I’d been on birth control for seven years without, I thought, any unusual side effects. But as my adult-onset acne continued to get worse and worse – and more resistant to medication – I had an epiphany. It was the pill.

And so, at 29 years old, I found myself going through the terrible task of experimenting with different types of birth control. I went through the Nuva Ring ($30 a month, after insurance) and several other pills (anywhere from $5 to $25 a month), in addition to the side effects that come with fluctuating hormones and medications. I gained weight overnight. I didn’t know if I was sad because my body was ballooning or because the pills were messing with my mood.

But I knew two things: I did not want to get pregnant, and any additional costs paled in comparison to caring for an infant. I had grown up in a working-class family in a small town 40 miles north of Philadelphia, and a few of my friends had had babies in high school. I, however, was at the top of my class and determined to be the first in my family to finish college immediately after high school. Kids weren’t in my game plan.

I moved to DC, finished college, went on to get my Master’s degree and now work at a nonprofit. I also met my partner of almost 10 years when I was 22, and together we started to build a life. He was supportive as I worked through many birth control options that terrible spring, and it turned out I had excellent timing. As I narrowed in on the intrauterine device (IUD) the Affordable Care Act began to cover birth control, and I didn’t have to worry about cost. I was charged nothing for the IUD or the insertion, which my doctor told me would cost $1,200 without insurance.

On Sunday, my partner and I bought a house in Alexandria, and we hope to soon start a family there. But that house and our wonderful, financially sound life together wouldn’t have been possible without access to birth control, the same access that the supreme court threatens take away from women and their doctors and put into the hands of CEOs. Let’s hope they don’t.

American University student Abby Loisel wears stickers from birth control pills. Photograph: Chip Somodevilla / Getty

My family, my faith, my decision

By Ann Marie Benitez, director of government relations and public affairs at the National Latina Institute for Reproductive Health

I remember when I landed my first job that offered health insurance. I was thrilled about the job – and that I would finally have access to more affordable birth control. But I was still paying $30 or more per month, which was not easy on my family’s budget. Then came the Affordable Care Act, which provided me – along with over 27 million women in the US, including nearly 5 million Latinas, access to contraception without co-pay.

I’ve always believed women should make their own decisions about birth control – and the issue got personal for me when my husband and I decided to start a family. In our perfect world, we wanted three kids. Our planning took into account many factors, but we knew that birth control was necessary.

In 2009, our first little guy was born. Over the next several months we savored each moment. When my son was almost one and a half, my husband and I started talking about having another baby. Amid our cheerful planning we got the devastating news: my husband had cancer.

Our lives stopped. So did plans for a second child. From the moment of diagnosis, everything we did was focused on one goal: keeping my husband alive. During this tumultuous time, birth control provided us with some peace of mind because it gave us confidence that our already exhausted resources wouldn’t be put at further risk with an additional child.

Fast forward a few years. My husband’s cancer is in remission. We’ve had our second child. That third one still seems pretty out of reach. Birth control is still necessary.

But the case before the supreme court could change everything again. These court challenges are being brought by corporate executives who want to deny their employees contraceptive coverage – despite the reality that the majority of US voters, including 89% of Latina voters, support the birth control benefit.

I cannot imagine the trajectory my life could have taken if I didn’t have the ability to plan for what was best for my family – to exercise my own moral agency as a person of faith. Today I am a mother of two wonderful children, a wife of a cancer survivor, and I’m helping to lead the charge to build the power of Latinas like me to advocate for health, dignity and justice. None of that would be possible without affordable birth control.

From religious employers

Protesters pray at the steps of the supreme court. Photograph: Larry Downing / Reuters

My employees, my choice, my lawsuit

By Mary Anne Yep, vice president and chief personnel officer of Triune Health Group

My husband and I started our business over 20 years ago, but our belief in God and our walk in faith began long before that. So did our gratitude for living in America, governed by a constitution and bill of rights. Our understanding and acceptance of the basic truth of the dignity and value of every human being – from conception to death – is a tenet of our foundation. It’s personal and professional. It’s what has made our business grow.

Our employees know who we are and what we stand for. We are a diverse group: 80 people of different races, creeds, ages, genders, political leanings and ethnicity. They are all aware of our lawsuit against the governmental overreach through the Health and Human Services mandate, which is before the supreme court. Instead of our suit dividing us, our employees trust us, because they experience the actions behind our words – respect and concern for their lives, top salaries and good benefit packages, to name just a few.

Our employees know we are fighting not only for our right to choose but also for their right to choose. For them, that right to choose comes in deciding whether they want to work for us. Some people choose not to work for us, but those that do are very happy.

In filing our lawsuit, our company is simply asking our government to respect our dignity and our rights as human beings, which are guaranteed by God and our constitution and our bill of rights. As a woman, I have taken many classes learning how to define boundaries, to speak up when I am being bullied or victimized. That is what we are doing. I so appreciate my fellow businesswomen who have supported our efforts. Our victory will be a victory for all.

From religious right-to-choicers

Protesters rally at the steps of the supreme court holding Catholics for Choice signs. Photograph: Larry Downing / Reuters

Some guy, some Catholic, some sense

By Jon O’Brien, president of Catholics for Choice

Sandra is a young science teacher in the midwest. She took a pay cut to do the type of work she loves at a Catholic school. But the budget she and her husband had carefully planned ran into an unexpected expense.

Sandra was just trying to fill her usual, non-generic birth-control prescription. Paying out of pocket for the contraception that worked best for her was a significant hardship. But the absurdity of the situation was also not lost on her.

“I don’t like being told by some guy that I’ve never met that I can’t use it,” she said, referring to the diocesan bishop. “You also don’t have to be Catholic to work at a Catholic school,” Sandra pointed out, and even those who are Catholic may use birth control.

Sandra’s solution is a familiar one, voiced my many women today as the supreme court hears a case on whether an employer’s religious convictions merit an exemption for his or her company from covering contraception: “I think that as your own person, you should be able to do what you believe.”

Catholic teachings on the primacy of the individual conscience would agree with Sandra.

Unfortunately, her contraception coverage, and that of many others, was already bargained away in earlier exemptions for religiously affiliated institution. But no matter who a woman works for, it doesn’t make sense for “some guy” – whether a boss or a bishop – to step into the personal, private decisions every Sandra is well-equipped to make on her own.

From readers – and you

Anything but the Catholic company’s birth-control system

By Rachel Sherman (Ferndale, Michigan)

My husband got a new job back in October. He works for a Lutheran health system now. Feels downright liberal in comparison.

According to the insurance through the Catholic hospital system, I had to have my doctor fax in a form explaining why the birth control was medically necessary. I have poly cystic ovarian syndrome (small cysts on the ovaries). My gyno refused to fill out the form and send it in, so the Catholic system never covered my birth control while my husband worked there. I’m going to find a new gyno soon for multiple reasons: her refusal to send the fax, for one, and her tendency to only put me on the most recent birth control available hurt me financially.

Under the Lutheran hospital system insurance, you do not need to fill any form or give explanation. They push you to take generics, but then most insurance companies do that these days. Currently, I’m paying $10 a month (my co-pay) for Junel Fe, a generic form of Loestrin. It is doing the job just fine. It’s so much better than paying $80 to $85 a month for Lo Loestrin or Yaz while my husband worked in the Catholic system.

Ed note: in 2012, we asked readers for their contraception stories. Here’s a flashback to what Rachel wrote us then.

My husband works for a Catholic hospital group. We were told that I could get coverage for my birth control if my gynaecologist filled in a form and faxed it to CVS Caremark explaining that I need the hormones from the birth control to treat my hormone imbalance and control the cysts on my ovaries. She told me she did not believe that would make any difference and gave me a card from the pill distributor for a discount. The discount only takes off 10 dollars a month from the price of the pill. Needless to say paying for birth control is a hefty chunk of my budget.

Protesters hold signs at the steps of the supreme court. Photograph: Larry Downing / Reuters

The US employer’s healthcare obsession

By Nicky (Seattle)

I grew up in the UK, and now I find myself in the slightly odd position of being an advocate of a single-payer system while working for a US health insurance company.So I’m lucky to have a comparatively generous package with very low monthly premiums. Because of this, and because of the delay in implementation of some Affordable Care Act provisions affecting large employer groups, I haven’t really seen many changes to the coverage I can get.

I do know that some of my colleagues who have small children have benefited from having access to equipment like breast pumps which haven’t typically been covered. And I know that my contraception costs have changed from the $60 per month I was paying in 2012, because I’ve switched to a lower-cost type of birth control.

The system in the US already means that employers are more involved in their employees’ health than we would probably consider acceptable in the UK. For example, every year, I have to have a physical where my blood pressure, weight, cholesterol and blood glucose are measured and those results are shared with my company. If I’m over weight or have high cholesterol, I have to commit to taking action to address those issues. If I don’t make that commitment – or if I refuse the screening –I have to pay a higher monthly premium than my colleagues. My husband, who I cover on my insurance, is also required to do this. The difference in rates is over $600 a year.

I find myself almost constantly dismayed that American women aren’t standing up to the state legislatures full of older white men who are legislating based on their own personal religious convictions, rather than what is in the best interests of the women and children in their constituencies. (I hope that the UK’s politicians and businesses have more important things to concern themselves with!) Under the current system, health coverage for most working Americans is inextricably linked to their employment. Employers already make decisions about what coverage they will provide, and the debate over this birth control provision is just another way in which employers’ concerns have more weight than the concerns of workers receiving care.

Have your say: what does affordable birth control mean to you? What do you think of today’s supreme court fallout? Speak out in the comments below the line …