In a decision handed down Wednesday, the Supreme Court upheld the Trump administration's efforts to expand exemptions for employers seeking to claim religious or moral objections to the Affordable Care Act's (ACA) contraceptive mandate. As a result, more employers will now be able to cite religious objection as their reasoning for refusing to include birth control coverage in employee health plans. While supporters argue the decision safeguards businesses' religious freedom, reproductive health advocates fear the Supreme Court's ruling could hinder access to birth control for hundreds of thousands of people.
In examining Little Sisters of the Poor v. Pennsylvania and Trump v. Pennsylvania, two cases which were combined by the court, Supreme Court justices ruled 7-2 to uphold the Trump administration's expanded exemptions to the ACA's contraceptive mandate. That mandate defined birth control as a preventive health service that all employers aside from churches and houses of worship were required to provide free of charge in employee health care plans. Upon taking office in 2017, President Donald Trump moved to expand the types of businesses that could claim exemption from the mandate on religious or moral grounds.
"We hold today that the Departments had the statutory authority to craft that exemption, as well as the contemporaneously issued moral exemption," Supreme Court Justice Clarence Thomas wrote in the court's majority opinion. "We further hold that the rules promulgating these exemptions are free from procedural defects."
Chief Justice John Roberts joined Justices Samuel Alito, Neil Gorsuch, and Brett Kavanaugh in joining the majority opinion authored by Thomas while Justice Elena Kagan authored a concurring opinion that was joined by Justice Stephen Breyer. Justices Ruth Bader Ginsburg and Sonia Sotomayor were the only two justices to dissent.
Wednesday's ruling is undoubtedly a victory for the Trump administration, which has long sought to chip away at provisions within the ACA. But it comes with a price: hundreds of thousands of people could lose their birth control coverage due to the Supreme Court's ruling. The government had previously estimated that expanding employer exemptions to the mandate would cause up to 126,000 people to lose their contraception health coverage in just one year, according to NBC News.
Unfortunately, multiple barriers to contraceptive access already exist. Between misconceptions, prescription requirements, doctor's visits, and insurance costs, people often already face enough hurdles when trying to obtain birth control. Reproductive rights advocates slammed the court's ruling, cautioning that employers' personal beliefs had no place in employees' private health care decisions and could further restrict access.
"Contraception should not be singled out from the rest of health insurance coverage," Lourdes Rivera, senior vice president of U.S. Programs at the Center for Reproductive Rights, said in a statement shared with Romper. "Today's ruling has given bosses the power to dictate how their employees can and cannot use their health insurance — allowing them to intrude into their employees' private decisions based on whatever personal beliefs their employers happen to hold."
The National Women's Law Center called the decision handed down Wednesday "disastrous" and "dangerous" for employees. "Thousands of people could now have their birth control coverage determined by their boss. It's invasive, archaic, and dangerous," the non-profit tweeted. "Today's ruling is especially cruel because it will have the most negative impact on those who already face barriers to health care: Low-wage workers, people of color and LGBTQ people."