Advocacy & Health Policy: Supreme Court to Hear Two Major Women’s Health-Related Challenges

Texas Abortion Restriction Law

The United States Supreme Court will review Whole Woman’s Health v. Cole, the most significant case related to abortion rights since 2007. Whole Woman’s Health v. Cole challenges a Texas law, which imposes stringent regulations that require facilities providing abortion to obtain hospital admitting privileges and comply with ambulatory surgical center standards. Since the bill’s enactment in 2013, the number of clinics providing abortion care in the state has dropped by nearly 60 percent, from 41 clinics to 18. Experts predict that if the law is upheld, that number will fall to nine.

Mark S. DeFrancesco, MD, in a statement on the Supreme Court’s decision, affirmed that the Texas law, “under the guise of protecting the safety of women, would actually restrict access to safe, legal abortion.”

ACOG has been a leading voice against this dangerous law. Joined by the American Medical Association, the American Academy of Family Physicians, and the American Osteopathic Association, ACOG petitioned the Supreme Court to hear the case and also filed an amicus when the case was before the Fifth Circuit Court of Appeals. The Supreme Court is expected to hear arguments next spring and to issue a decision in the summer.

ACA Birth Control Challenge

The US Supreme Court announced it will hear arguments in all seven of the challenges to the birth control benefit of the Affordable Care Act (ACA) pending before it. The birth control benefit guarantees women insurance coverage of the full-range of birth control methods without any out-of-pocket costs, while allowing non-profit institutions opposed to contraception to opt-out of including it in their employees’ insurance plans.

The Supreme Court will consider whether the birth control accommodation meets the protections in the Religious Freedom Restoration Act, which requires the government to provide a "compelling reason" for measures that "substantially burden" religious beliefs, this time in the case of religious non-profits.

Last year, the US Supreme Court ruled, in Burwell v. Hobby Lobby, that closely-held, for-profit companies with religious objections to covering birth control can opt-out of the requirement to provide contraceptive coverage to their employees. The cases before it now are brought by non-profit religious universities and other entities.

The accommodation allows nonprofits opposed to birth control to exclude it as a benefit from their health insurance plans, in which case an employee could get coverage directly from her insurance company. The plaintiffs argue that the accommodation does not go far enough to protect their religious beliefs, because they must provide notification that they wish to deny their employees the benefit in order for the coverage to be facilitated separately.

ACOG has been a strong supporter of this essential benefit provided in the Affordable Care Act. A recent study published in Health Affairs found that women have saved $1.4 billion on birth control because of this benefit, whereas before the ACA went into effect, contraceptive costs accounted for between 30 percent and 44 percent of women’s total out-of-pocket health care costs. The Court is likely to hear the challenge in the spring and issue a ruling before the end of its term in June.  

As these opinions are issued, ACOG will keep you apprised in ACOG Rounds, Today’s Headlines, and ACOG News.”

American Congress of Obstetricians and Gynecologists
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