The latest Supreme Court decision will leave some endometriosis patients in a lurch, as their employers decide what medication patients can and cannot have based on religious beliefs, leaving yet more hurdles for endometriosis patients to face.
In August of 2011, the Department of Health and Human Services announced a new mandate for for-profit corporations, under the Affordable Care Act. Companies needed to provide comprehensive insurance coverage to their employees that included a contraceptive mandate which provided, co-pay free, 20 different FDA-approved contraceptive methods. If corporations did not want to provide insurance for their employees, they had the ability under the ACA to pay a penalty instead. 6 companies, including Eden Foods, sued the Department of Health and Human Services stating that providing their employees contraception was in violation of the their protected rights under the Religious Freedom Restoration Act of 1993 and that the penalty was too onerous. They did not want to provide any birth control methods, including medications that endometriosis patients rely on.
Right before the Affordable Care Act was about to be enforced, many companies founded by religious owners started suing the government. In a 2013 interview with Irin Carmon from Salon.com, Eden Foods Owner, Michael Potter, was quoted saying he was suing the government, “Because I’m a man, number one, and it’s really none of my business what women do… I don’t care if the federal government is telling me to buy my employees Jack Daniels or birth control. What gives them the right to tell me that I have to do that? That’s my issue, that’s what I object to, and that’s the beginning and end of the story.” He added, “I’m not trying to get birth control out of Rite Aid or Wal-Mart, but don’t tell me I gotta pay for it.” It also should be noted, that on their website they tout that their benefits also do not cover “lifestyle drugs,” which includes coverage for infertility treatment.
The Department of Health and Human Services argued against Eden Foods in court, saying that when a person decides to form a corporation and gain the tax and liability benefits and protection of a corporation, he or she is not a person anymore, therefore NOT protected under the Religious Freedom Restoration Act. The Sixth Circuit Court agreed and stated, “By incorporating his business, Potter voluntarily forfeited his rights to bring individual actions for alleged corporate injuries in exchange for the liability and financial protections otherwise afforded him by utilization of the corporate form. Adoption of Potter’s argument that he should not be liable individually for corporate debts and wrongs, but still should be allowed to challenge, as an individual, duties and restrictions placed upon the corporation would undermine completely the principles upon which our nation’s corporate laws and structures are based.” Similar cases in the lower courts had similar resolutions.
In the recent Supreme Court Case, Burwell v. Hobby Lobby, the giant craft store chain took on the Department of Health and Human Services stating that although it provided 16 out of the 20 contraceptive methods, due to its Christian beliefs, it did not want to provide 4 of the methods on the list, including Plan B, Ella, Mirena IUD and the Paraguard IUD. Hobby Lobby stated it refuses to provide these four birth control methods on the grounds that they are similar to having abortions, despite the fact that the FDA has explicitly said that none of these contraceptive devices are abortifacients.
In a disappointing turn of events, this week the Supreme Court has decided to rule in favor of Hobby Lobby, stating that based on religious beliefs, closely held companies can opt out of the Affordable Care Act’s contraception mandate. This ruling will allow Eden Foods, and any companies who are against birth control methods, to forgo coverage for contraception all together. This ruling would apply to 90% of all American businesses and 52% of the workforce.
On a practical level, endometriosis patients who work for companies that choose to opt out of the contraceptive mandate, who rely on hormonal treatments such as birth control pills or the Mirena IUD, are out of luck unless Congress or the Obama administration finds a way to pick up the tab. There has been no talk of a medical exclusion for patients that need these hormones to function. Speaking of medical exclusion, it seems that none of these companies who are focused on “fighting for their religious freedom” even consulted the medical community on what would be best for their employees. Churches should not be making medical decisions for endometriosis patients, informed doctors should be.
On a deeper level, this insidious Supreme Court Decision has a profound effect on the lives of infertility and endometriosis patients everywhere. The Supreme Court told endometriosis patients yesterday that they view a corporation as a person, and essentially the corporation’s religious views are more important than the health of the endometriosis patients that work for the corporation and the advice of their medical doctors. If endometriosis patients can’t even get coverage for birth control from their religious employer, the idea of ever being covered for infertility treatments, seen as controversial by some religious institutions, now seems completely hopeless. Infertility isn’t a lifestyle, like Eden Foods owner Michael Potter might argue, it is a medical issue that deserves medical treatment and we ALL have a RIGHT to be covered.
Why do religious beliefs of the corporate hierarchy affect medical choices that women make to treat their diseases? Why is the Supreme Court supporting this? Each judge on the Supreme Court takes an oath to “administer justice.” Endometriosis excision surgery, the only true way to battle this disease, is not affordable and accessible to all endometriosis patients as of yet. The majority of doctors who treat endometriosis do not know how to do excision surgery, but they will prescribe hormones to try and manage the disease for as long as possible. Now that won’t be an option for women living daily in excruciating pain? How is this justice?
Casey Berna is a patient of Dr. Seckin’s and an endometriosis and infertility counselor and advocate. To learn more about her story and her practice go to www.CaseyBerna.com. If you are a patient of Dr. Seckin’s and want to share your story please contact Casey at [email protected].