Union Leader Calls Claim That Gender Discrimination Will Result From Hobby Lobby Decision “Factually Incorrect”

Union Leader: “No Woman Is Being Denied Coverage Of Their Basic Health Needs By [The Hobby Lobby] Decision.” The July 12 Union Leader editorial rejected the factually accurate claim made in a press release by Gov. Maggie Hassan (D-NH) that denying some forms of FDA-approved contraception would deny women the full scope of their medical compensation. The paper also furthered the inaccurate claim that the disputed forms of contraception caused abortions:

“When women are denied health insurance coverage that covers their basic health needs ... then women are unfairly being compensated less than their co-workers.”

So says Gov. Maggie Hassan, in a release pushing a federal bill.

Apart from being factually incorrect, why is such a blatantly political statement posted on the state-owned and state-operated official website of New Hampshire's governor?

Actually, we know the answer. The Democrats nationally have made no secret of the fact that they intend to use the so-called Hobby Lobby U.S. Supreme Court decision to gin up political support and campaign dollars. Gov. Hassan wants to help.

It should also be no secret that no woman is being denied coverage of their basic health needs by this decision. The owners of Hobby Lobby craft stores were paying for 16 types of birth control before Obamacare ordered them to. But they objected to being forced to pay for four contraceptives that they believe amount to abortion.

The court agreed and pointed out that if government wants to make employers provide abortifacients, it should pay for them itself. [Union Leader, 7/12/14, emphasis added]

Full Statement From Governor Hassan Explained How Denial Of Contraceptive Insurance Amounts To Less Compensation For Women Compared To Men

Gov. Hassan: Health Insurance Including Contraceptive Drugs Are “Part Of A Worker's Compensation, Not A Gift.” Governor Hassan's press release supporting the introduction of the Protect Women's Health from Corporate Interference Act as a response to the Supreme Court's Hobby Lobby decision stated that to deny part of women's basic health insurance was to effectively compensate them less for their work compared to male co-workers who would receive “full coverage for their basic health care”:

Company-provided health insurance is part of a worker's compensation, not a gift. When women are denied health insurance coverage that covers their basic health care needs, but their male colleagues receive full coverage for their basic health care, then women are - unfairly - being compensated less than their co-workers. Contraception costs are one of the biggest health care expenses for women and their families. Affordable access to this basic health care coverage is critical to the economic security of women and families. [Office of Governor Hassan, 7/8/14]

Legal Experts Agree That Denial Of Full Contraception Coverage Amounts To Gender Discrimination

National Women's Law Center: “Employers That Exclude Women's Preventive Health Services From Their Health Insurance Plans While Covering Men's Preventive Services Discriminate Against Women.” The National Women's Law Center explained that as part of the preventive health services recommended by the Institute of Medicine, contraceptive coverage without cost sharing will make great strides for gender equality because “women disproportionately [bear] the costs of reproductive health care, and these high costs negatively affected women's health and well-being.” They further explained:

Providing contraceptive coverage without cost-sharing corrects gender gaps in the provision of health care by ensuring that women, like men, can meet their basic preventive health care needs. Before the ACA went into effect, women disproportionately bore the costs of reproductive health care, and these high costs negatively affected women's health and well-being, as women often lacked access to or forewent necessary health care to keep costs down.

The contraception regulations address this disparity and advance equal opportunity in other aspects of women's lives, thus improving women's social and economic outcomes more generally.

[...]

Employers that exclude women's preventive health services from their health insurance plans while covering men's preventive services discriminate against women. Such exclusion means that women are denied the comprehensive preventive health coverage provided to men. Moreover, when effective contraception is not used, and unintended pregnancy results, it is women who incur the attendant physical burdens and medical risks of pregnancy, women who disproportionately bear the health care costs of pregnancy and childbirth, and women who often face barriers to employment and educational opportunities as a result of pregnancy. [Brief for the National Women's Law Center in Support of the Government, 1/28/14, emphasis added]

National Women's Law Center: “Standards Of Medical Care Recommend That Women Have Access To Contraception As A Necessary Part Of Critical Preventive Health Care Services.” The National Women's Law Center concluded that contraception's role in preventive care extending beyond birth control qualifies the drugs as a necessary part of health care and should be covered by group benefits:

Standards of medical care recommend that women have access to contraception as a necessary part of critical preventive health care services. The contraceptive coverage provision at issue here makes this access possible by ensuring that health plans in the individual and small group market adequately cover services that ensure women's health and wellbeing. [Brief for the National Women's Law Center in Support of the Government, accessed 7/14/14]

Basic Medical Needs Might Not Be Met As Non-Disputed Forms Of Contraception May Not Be Best Option For All Women

Experts: Patients And Doctors Should Be Allowed To Make Medical Discussions Together Because “Not All Contraceptives Are Clinically Appropriate For Every Women.” According to an amicus curiae brief filed by the American College of Obstetricians and Gynecologists and other medical organizations in support of the contraceptive mandate, not every form of contraception is appropriate for each patient and some of the disputed forms of birth control would be better suited for some women than others:

Deciding on the best form of contraceptive for any specific patient should take place within the shared responsibility of the provider-patient relationship. Like other decisions, the welfare of the patient should receive the highest priority in the consideration of appropriate contraceptive use. Not all contraceptives are clinically appropriate for every women.

[...]

A variety of individualized factors must be considered, including, for example, a patient's current health and medical conditions, potential drug interactions, medical history, stage of lie, and religious and personal preferences.

More particularly, LARCS, such as implants and IUDs, may eb preferable for women who require highly effective methods, who wish to postpone pregnancy for an extended length of time, and who desire or need a method that is effective without the user taking regular action once it is initiated. Emergency contraception pills or devices are used by women to prevent pregnancy after rape, unprotected sex or the failure of some other contraceptive.

[...]

Hormonal birth control pills or a hormonal IUD may not be suitable for women with certain medical conditions such as heart of liver disease, women who have certain blood-clotting disorders, or who have had or are at higher risk of certain types of cancer. [...] Oral contraceptives may be inappropriate for women who smoke. [...] Use of certain contraceptives may be contraindicated based on adverse interactions with other medications a women is taking, or based on certain lifestyle factors that could make certain forms of contraception inadvisable. Id. All of these factors concerning a women's medical and personal circumstances, and the patient's own personal beliefs, should be weighed by health care providers when advising her about her contraception choices.

To best serve the particular medical needs of their patients, physicians must have available to them an array of contraceptive options from which to recommend in order to ensure that the particular method prescribed optimally meets the particular medical and personal circumstances of the patient. [Brief of Amici Curiae, 1/28/14, via American Bar Association]

The Disputed Contraceptives Do Not Induce Abortion

Former FDA Assistant Commissioner: “These Products Are Not Abortifacients. And Their Only Connection To Abortion Is That They Can Prevent The Need For One.” According to NPR, studies have shown that “morning-after pills” such as Plan B work by “preventing ovulation, and therefore, fertilization” and do not “inhibit implantation”:

The constant references to Plan B and ella as abortion-causing pills frustrates Susan Wood, a professor of health policy at George Washington University and a former assistant commissioner for women's health at the FDA.

“It is not only factually incorrect, it is downright misleading. These products are not abortifacients,” she says. “And their only connection to abortion is that they can prevent the need for one.”

[...]

For years, scientists knew the pills, particularly Plan B, were highly effective in preventing pregnancy after unprotected sex but weren't exactly sure how they managed that. “It wasn't really clear whether it worked before ovulation or after ovulation,” says Wood.

Scientists did know the drug worked primarily by preventing ovulation. It stops an egg from being released from a woman's ovary and thus prevents any chance of fertilization and pregnancy. But they also thought the drug might make it more difficult for a fertilized egg to implant in a woman's uterus.

Technically, that's not an abortion, says Wood.

“We know that about half of fertilized eggs never stick around. They just pass out of the woman's body,” she says. “An abortifacient is something that interrupts an established pregnancy.”

But people like [Gene] Rudd [senior vice president of the Christian Medical and Dental Associations and a practicing OB-GYN in Bristol, Tenn.] worry that even if what the drugs do is not technically abortion, it's still objectionable if it happens after fertilization.

But it turns out, at least when it comes to Plan B, there is now fairly definitive research that shows the only way it works is by preventing ovulation, and therefore, fertilization.

“We've learned a lot about how these drugs work,” says Diana Blithe, a biochemist and contraceptive researcher at the National Institute of Child Health and Human Development. “I think it's time to revise our speculations about how things might work in view of data that show how things do work.”

For example, says Blithe, a study published just last year led the International Federation of Gynecology and Obstetrics to declare that Plan B does not inhibit implantation. And some abortion opponents in the medical community are beginning to accept that conclusion.

“Up until recently I would not prescribe the Plan B product because we didn't have enough science to say it doesn't have a post-fertilization effect,” says Rudd. “Now, I'm becoming -- sitting on the fence with that.” [NPR, 2/21/13, via Media Matters]

New York Times: Morning After Pills “Delay Ovulation” And Do Not Disrupt Fertilized Eggs. The New York Times explained that the claim that morning-after contraception disrupts fertilized eggs is misleading and inaccurate, and points out that in reality, the morning after pill delays ovulation to prevent pregnancy:

But an examination by The New York Times has found that the federally approved labels and medical Web sites do not reflect what the science shows. Studies have not established that emergency contraceptive pills prevent fertilized eggs from implanting in the womb, leading scientists say. Rather, the pills delay ovulation, the release of eggs from ovaries that occurs before eggs are fertilized, and some pills also thicken cervical mucus so sperm have trouble swimming.

It turns out that the politically charged debate over morning-after pills and abortion, a divisive issue in this election year, is probably rooted in outdated or incorrect scientific guesses about how the pills work. Because they block creation of fertilized eggs, they would not meet abortion opponents' definition of abortion-inducing drugs. In contrast, RU-486, a medication prescribed for terminating pregnancies, destroys implanted embryos. [The New York Times, 6/5/12, via Media Matters]

National Catholic Reporter: “There Is Overwhelming Scientific Evidence That The IUD And Plan B Work Only As Contraceptives.” Prize-winning religious scholar Jamie L. Manson explained in the National Catholic Reporter that the “overwhelming scientific evidence” shows that “there is only one drug approved to induce abortions,” and neither IUDs nor morning-after contraception, more commonly known as “Plan B,” are considered to be that drug:

The reality is that there is overwhelming scientific evidence that the IUD and Plan B work only as contraceptives. Since Ella is new to the market, it has not been studied as extensively. But as of now, there is no scientific proof that Ella acts as an abortifacient, either.

There is only one drug approved to induce abortion. It is called RU-486 (mifepristone) and is not on the FDA's list of approved contraception. It is available only by prescription and no employer is forced to pay for it as part of an employee health plan.

To understand why scientists believe that the IUD, Plan B and Ella are not abortifacients, it is important first to understand the biology of conception. In order for a woman to become pregnant after sexual intercourse, her ovaries must release an egg (ovulation). Sperm can remain viable inside her reproductive tract for five days. Therefore, if intercourse takes place up to five days before ovulation or within two days after, both sperm and egg are viable and the egg cell can be fertilized.

Now, just because an egg is fertilized doesn't necessarily mean that it will develop into an embryo. For that to happen, the fertilized egg must be implanted into the endometrium that lines the uterus. Implantation happens seven days after fertilization, if it happens at all. Scientists estimate that, at a minimum, two-thirds of fertilized eggs fail to implant. Some scientists estimate that the number may even be as high as 80 percent, according to Discover Magazine.

For this reason, according to the medical definition, a woman is not considered pregnant until the developing embryo successfully implants the lining of the uterus. [National Catholic Reporter, 2/20/12 via Media Matters]