Contraceptive care is already an out-of-pocket expense for many women, and a new provision could make it even harder for them to access this care for free.

On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act, which would expand medical insurance coverage, including contraceptive care. But a new proposal from Kathleen Sebelius, the U.S. secretary of health and human services, suggests that universities, schools and hospitals be part of the exemption for providing contraceptive care in health plans. Religious schools and institutions already qualified for the exemption.

Obama still has yet to announce his decision about the provision.

“I think it’s really the Catholic bishops that are putting the most pressure on the president to provide what they’re calling a ‘conscience exemption’ for this,” said Democratic Rep. Katie Hobbs, from District 15 of the Arizona State Legislature. “What’s frustrating to me is you have 227 bishops that are supposed to be speaking for an entire church, but 99 percent of Catholic women have used birth control.”

Hobbs added the bishops aren’t really speaking about the people in their churches and she said it should be up to each individual whether or not they choose to use contraceptives.

As of now, exemptions are limited, said Republican Sen. Nancy Barto, from District 7, in regard to the new provision.

“If they provide an exemption to health plans and insurers that they don’t have to cover it (contraceptives) based on their moral convictions, then that’s an improvement to prior guidelines,” Barto said.

Bryan Howard, the president and CEO of Planned Parenthood Arizona, said the Patient Protection and Affordable Care Act requires that Americans have access to basic prevention-oriented services. Planned Parenthood is encouraging the administration to stand behind this act, which already expands an exemption to places of worship, Howard said.

Preventive services could include diabetes or HIV prevention, Barto said. But drugs and procedures that prevent pregnancy “have obvious morally-objectionable implications for a lot of people in the health care industry. To mandate that all insurers cover them and provide them, at no cost, is really an unprecedented move for the federal government.”

Barto said the government needs to respect freedom of conscience.
Howard said the law shouldn’t be broadened to non-religious places or workplaces that aren’t specifically about religion.

“To have this proposal go forward will really discriminate against employees of all faiths,” Howard said. “It’s really out of step with the view of mainstream Americans.”

Republican Sen. Linda Gray, from District 10, said contraceptive care should be the “personal responsibility” of individuals, not the taxpayers.

“They should be paying on their own,” Gray said.

Barto said if the provision goes through, it would put the decision back into women’s hands. They would be the ones to decide how to deal with her health care service.

“But it doesn’t put the burden of providing for potentially life-ending services or devices in the hands of mandating insurers to provide it,” Barto said. “So it definitely puts the responsibility where it belongs.”

Hobbs said the provision impacts reproductive health care. She added that there are “gender disparities” in health insurance coverage and a more inclusive approach would make access more equal.

“I really don’t think you have a right to say ‘you can take birth control or can’t, or if you do, you have to pay for it out of your pocket,’” she said.

If the proposal goes through, Hobbs said, “I definitely think it will have some electoral consequences. I think women are a large voting block and this is an issue that’s important to women.”

Hobbs and Howard said they agree this proposal would be a reversal of the progress made so far for reproductive rights.

Barto said the exemptions of the provision “should include anybody that morally objects because it has to do with ending life.”

Howard said at some point in everyone’s lives, birth control plays a role in planning education and careers so people “can afford the families they want to have.”

“This is really trying to roll back 50 years of health care progress,” he said.