The U.S. Supreme Court’s decision in the Hobby Lobby case is a serious step backward for women’s health. It has the potential to not only impact many of the almost 3 million women in California, who saved an average of $269 last year on birth control, but sets a dangerous precedent where bosses are in control of their employees’ personal health decisions.
The owners of Hobby Lobby, a national chain of arts-and-crafts stores, and Conestoga Wood Specialties, a kitchen cabinet-making company, do not believe – because of their religious faiths – that they should provide health insurance coverage that includes certain kinds of contraceptives.
Let us make clear that we respect the rights of others to have their own personal beliefs. However, in exercising these beliefs, the owners of Hobby Lobby are denying scientific fact, imposing their own religious beliefs on their employees and restricting employee access to important preventive care. They are preventing women from receiving access to a form of contraception that can minimize health risks and permit planning for healthier pregnancies.
Contraception is essential health care that virtually all women will use at some point in their lives. As doctors, we know that for a woman to make the best decision about the kind of birth control that is right for her, it’s important that she have access to all contraceptive options approved by the Food and Drug Administration. Long-term contraceptive methods, such as IUDs, are as much as 20 times more effective than the birth control pill at preventing pregnancy and are often the safest options for our patients. But the up-front costs make it difficult for some women, particularly low-income and hourly workers, to access birth control – something multibillionaire CEOs such as Hobby Lobby’s David Green may not understand.
We believe that health care decisions should be made between a patient and her doctor, not her boss. We have good company; 70 percent of Americans believe women should be able to make decisions about reproductive health care without interference from politicians or bosses. This Supreme Court decision only adds to the alarming number of state measures in recent years that have attempted to dictate what doctors must say to their patients, and what kinds of procedures are necessary.
And while the court tried to narrow its ruling to reproductive health and privately held corporations, Justice Ruth Bader Ginsburg warned of the “wide repercussions” and “startling breadth” of the decision in her dissenting opinion. She wrote that “its logic extends to corporations of any size, public or private. The Supreme Court has never granted a religious accommodation to a secular business that comes at the expense of its employees.”
Monday’s decision not only weakens preventive health coverage for some women, but by ruling in favor of corporations’ religious beliefs over employee religious freedom, the possibility remains that employers will be empowered to use their religious beliefs to withhold coverage of any type of health care they find personally objectionable. This could include exemptions to cover routine childhood vaccinations, refusal to cover emergency blood transfusions and denying life sustaining treatment for HIV/AIDS.
And since the ruling could open the door for additional for-profit corporations to challenge other laws based on religious beliefs, this could also ultimately pave the way for the erosion of hard-fought civil rights of all employees. Beyond health care this could mean compromising our California state laws that protect individuals from employment or housing discrimination based on his or her sexual orientation, erasing decades of progress for equality.
Allowing an employer’s personal values to trump employees’ right to health care allows the beliefs of the few to trump the health of many. That’s both bad policy and bad medicine. In light of the ruling, let’s hold bosses who choose to impose their personal beliefs on others accountable and let them know they have no place in our exam rooms.
Ami Bera, former chief medical officer for Sacramento County, represents California’s 7th Congressional District. Jeanne Conry, past president of the American Congress of Obstetricians and Gynecologists, is assistant physician-in-chief at North Valley Kaiser Permanente.