Overview
In early 2012, national debate intensified over a provision in the Patient Protection and Affordable Care Act (PPACA) requiring faith-affiliated hospitals and universities to include birth control coverage in employee health benefits.
Supporters viewed the policy as a step toward gender equality in healthcare, while opponents cited religious freedom concerns.
Legislative Background
The PPACA provision required most employers to include contraceptive coverage in health insurance plans. The law already included an exemption allowing houses of worship to exclude contraception from their employee plans. However, religious organizations sought a broader exemption that would cover religiously affiliated hospitals, universities, and charities.
House Speaker John Boehner criticized the policy, calling it “an attack on religious freedom.” He urged Congress to overturn the provision.
In contrast, Representatives Rosa DeLauro, Jan Schakowsky, Lois Capps, and Gwen Moore supported the rule, emphasizing that it balanced individual conscience with respect for religious beliefs.
State-Level Context
At the time, 28 states already required birth control coverage in employee health plans. Eight of those states did not offer any religious exemption. Many Catholic hospitals and universities already provide contraceptive coverage voluntarily, citing healthcare equality and consistency with employee benefits standards.
Statistics and Access
Surveys indicated that 99% of American women—including 98% of Catholic women—had used birth control at some point in their lives. Advocates argued that contraception is a routine part of healthcare and that the policy aimed to close long-standing gaps in prescription coverage.
Even with insurance, contraception costs could range from $600 to $1,200 annually. Advocates noted that while women faced out-of-pocket expenses for contraception, some prescription drugs for men, such as erectile dysfunction medications, were often fully covered.
Representative DeLauro described the new policy as ending “gender discrimination in prescription drug coverage,” ensuring that women’s health services received equal consideration.
Public and Institutional Reactions
The National Conference of Catholic Bishops and other religious organizations urged the administration to expand the exemption. They argued that requiring religiously affiliated institutions to provide contraception coverage conflicted with their moral teachings.
Conversely, public health advocates maintained that access to affordable contraception was a matter of medical necessity and individual rights.
Summary
The discussion reflected ongoing tensions between religious liberty, gender equity, and healthcare policy. The debate also revealed how national and state regulations intersect in shaping reproductive healthcare access.
Representative Schakowsky summarized the principle underlying the policy: “Your health care benefits shouldn’t depend on who your boss is.”