Is our health worth 10 minutes?
In its consideration of the Zubik v. Burwell case, the Supreme Court has a chance to correct a longstanding and systemic history of infringement of Black women’s reproductive rights: unequal access to contraception care and coverage.
The case centers on challenges from religiously affiliated nonprofit organizations that find the current accommodation – that an insurance company provide contraception coverage directly to employees when an organization chooses not to cover it for religious reasons – an undue burden.
The truth is that the denial or limitations of contraceptive coverage by employers causes an undue burden on women – especially Black women – by limiting their rights to determine their own reproductive care options.
The Affordable Care Act requires that most private health insurance plans cover comprehensive contraception care and services. Only houses of worship are not required to cover contraceptives. But many do.
Many Black women who choose to work at religious nonprofit organizations will suffer substantial harm if they are denied the access to contraceptive care that most female employees are entitled to. Charitable organizations, including nonprofit religious charities, employ more than 10 percent of the workforce. And, at least three in four employees are women, a significant percentage of whom are Black. The current accommodation applies to institutions including private grammar schools, universities, hospitals, health care networks, the YMCA and charitable organizations such as the Salvation Army. These women should not be forced to choose between their job – not to mention their family’s overall financial well-being – and their own reproductive and preventive health care.
If the current accommodation is not upheld, women who need contraception care and other reproductive health services will be forced to pay for them out of their own pockets. A very expensive proposition. Nearly one in four Black women lives in poverty. Black and white women earn only 64 and 78 cents on the dollar, respectively, when compared to white men. Their median weekly full-time wage according to the Bureau of Labor Statistics is $611. And that doesn’t include the 29 percent of Black women who work part-time because they are unable to find full-time employment. A woman earning less than $650 per week simply cannot afford the costs of effective contraception.
High costs also cause many women to choose less effective methods or even to forego contraception completely. As Justice Ginsburg pointed out in her dissent to the decision in the Hobby Lobby case two years ago, an IUD would be nearly a month’s full-time pay for workers earning the minimum wage. Cost barriers prevent consistent use of the most effective forms of contraceptives and contribute to an unplanned pregnancy rate for poor women that is five times that of higher-income women. The rate for Black women is twice that of white women. There is nothing more likely to thrust a woman into poverty than an unintended pregnancy.
Black women are also at greater risk for other health issues for which doctors recommend contraceptive use including diabetes, heart disease, lupus and HIV/AIDS. Blocking their access to contraceptive care puts them at increased risk for other diseases and life-threatening conditions.
To obtain an accommodation based on religious beliefs, an organization must submit the Religious Accommodation form provided by its insurance third party administrator. This takes about 10 minutes to complete. It is hard to believe that 10 minutes is an undue burden and that it denies the organization’s religious freedom. Every woman, regardless of where she works, should have the ability to access the reproductive care she needs. If these petitioners are exempted from the mandate that affords women that right, the Court will have given nonprofit religious organizations its seal of approval to infringe on individual women’s rights by denying those women equal access to the same contraceptive coverage granted to other women.
This court has long held that “women (and men) have a constitutional right to obtain contraceptives.” Congress, too, has deemed contraception “a medical necessity for women.” The court has already upheld the very accommodation being challenged in Burwell v. Hobby Lobby, in the context of for-profit employers.
From slavery to forced sterilization, our country has a long history of dispossessing Black women and women of color of their ability to control their reproductive health. That is not a history we should continue to write for the many Black women who work for religious nonprofit organizations.
The court should continue to protect women’s constitutional rights to religious freedom and to contraceptive care. A ruling in the petitioners’ favor would allow religious employers to impose a burden on the women who work for them and put the health and futures of Black women in jeopardy.
All to avoid 10 minutes worth of work.