Advocacy and Health Policy |

ACOG Statement on Zubik v. Burwell

Washington, DC—Mark S. DeFrancesco, MD, MBA, President of the American College of Obstetricians and Gynecologists (ACOG), released the following statement regarding today's oral arguments in Zubik v. Burwell:


"Today, the Supreme Court will hear arguments from religiously affiliated non-profit employers who want to create new obstacles for female employees and dependents seeking coverage for contraceptive services. These employers are not satisfied with the religious accommodation under the Affordable Care Act's (ACA) regulations that already allow them to exclude contraceptive coverage for the health insurance they arrange for their employees. ACOG strongly believes that contraception is an essential part of women's preventive care, and that coverage of contraception should be seamless.

"Access to contraception is a medical necessity for women during approximately 30 years of their lives. Obstetrician-gynecologists see firsthand the medical value of contraceptive services. Unintended pregnancies can have serious health consequences for women and can lead to poor neonatal outcomes. Allowing women to prevent pregnancy until they are ready can help women achieve optimal pre-pregnancy wellness, leading to healthier pregnancies and better outcomes for both a woman and her baby. For some women, preventing pregnancy can be life-saving. That's why the Institute of Medicine (IOM) recommended that contraception be included within the preventive services requirement under the ACA.

"Without question, contraception is an integral part of preventive care; women benefit from seamless, affordable access to contraception, and our health system benefits as well. Because of this, ACOG strongly supports the contraceptive mandate within the ACA. However, in the face of a religiously affiliated non-profit employer's sincerely held religious objection, we believe that the government's accommodation is the least restrictive means of providing the benefit that was put in place by the ACA. Under the government's accommodation, contraceptive coverage is seamlessly provided by the women's same insurer or administrator.

"Other proposed accommodations include insurance coverage obtained separately, obtaining services only at designated facilities, or requiring a cash outlay only possibly reimbursed through a tax credit. These alternative proposals - that do not exist for other health care services - all create additional cost or administrative hurdles to contraceptive coverage that is absent from the government's accommodation. And any alternative that leads to women having additional health care costs defies the original intent of the ACA mandate.

"That's why the government's accommodation is the most effective approach, and indeed is the only approach that will meet the government's compelling interest in providing women with seamless coverage of all IOM-recommended preventive care. As the U.S. Supreme Court stated in Burwell v. Hobby Lobby: 'In fact, [the U.S. Department of Health and Human Services] has already devised and implemented a system that seeks to respect the religious liberty of religious nonprofit corporations while ensuring that the employees of these entities have precisely the same access to all FDA-approved contraceptives as employees of companies whose owners have no religious objections to providing such coverage.'

"We urge the Supreme Court to recognize that the government accommodation is a sensible approach that protects women's access to contraceptive coverage. Any alternative or workaround would clearly be less effective and would leave certain women with coverage that is not equal to the standard of care as stipulated by the ACA.

"Once again, we ask that treatment decisions be made by women and their trusted health care providers."

ACOG's amicus brief in Zubik v. Burwell can be found here.

ACOG's Committee Opinion on Access to Contraception can be found here.

An ACOG/FLASOG/SOGC joint statement on Zika virus and contraception can be found here.

The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation's leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 58,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization.