Does Hobby Lobby Limit Women’s Access to Birth Control?

Other than their fear of a rising theocracy, the major concern of liberals in the wake of the Hobby Lobby ruling is that it represents a major setback for the cause of access to contraception. Ruth Marcus in the Washington Post today argues that the male members of the Supreme Court were incapable of appreciating the importance of such access because they lack uteruses, and so they failed to rule in a way that would ensure it was not undercut. (Ed Whelan eviscerates her column in a two-part post over at Bench Memos.)

Given this concern, it would make sense for someone to attempt to explain the reasons for believing that Hobby Lobby will have a dire effect on women’s access to birth control. At the New York Times’ home for data-driven explanatory journalism, The Upshot, Aaron Carroll takes a stab at it and concludes that the ruling “could limit access to birth control.” The problem is that his claim amounts to little more than an assertion.

“A growing body of evidence shows that it is already hard to obtain certain kinds of contraception, and the ruling seems likely to increase barriers,” he writes. In support of the first half of that claim he cites a study finding that 6 percent of pharmacists surveyed in Nevada said they would refuse to dispense certain drugs, including contraception and abortifacients, for moral or religious reasons. He then describes a separate study, which found that a fifth of pharmacies surveyed in five U.S. cities told researchers posing as adolescents they did not carry emergency contraception at all, and that this was more likely to be the case in low-income areas.

So that’s the evidence for the existing barriers. How will the decision in Hobby Lobby likely increase them?

If other family-owned corporations choose to emulate Hobby Lobby and win an exemption from the Affordable Care Act’s requirement for broad coverage of contraception, cost will become a higher barrier for more women. Emergency contraception costs, on average, $45 without insurance.

But the studies he cites deal with the availability of contraception at pharmacies, not its costs. On the former point, Hobby Lobby has no effect on pharmacies and individual pharmacists carrying and dispensing emergency contraceptives. The post does not consider the question of how many closely held corporations owned by people with religious objections to some forms of contraception might alter their insurance arrangements in the wake of the case. Women employed at such companies would be the ones who might actually be affected by the ruling.

And the idea that the ruling means “cost will become a higher barrier for more women” in the situations he’s described seems highly questionable. Any woman who has a job that provides her with health insurance, i.e. the women who benefit from the HHS mandate requiring that their employers cover their birth control, is unlikely to be unable to afford to pay $45 for a morning-after pill on occasion.    

Carroll’s next data point is that IUDs are expensive and women whose insurance does not cover them might have trouble affording them. He tells us that in North America, 2 percent of women use IUDs. I’m not sure if he thinks that absent Hobby Lobby there would have been a surge in IUD use that will now not occur, or whether some women who had their IUDs covered by their insurance will now have to switch to less reliable means of birth control, but in either or both cases, the effect seems closer to negligible than noticeable. 

The rest of his post is devoted to arguing against the notion that the four methods of birth control and emergency contraceptives that Hobby Lobby’s owners objected to can act as abortifacients. He cites some studies supporting the conclusion that they likely do not. He does not mention the fact that the FDA admits the possibility that they may act to prevent implantation of an embryo.

Carroll writes:

The scientific consensus is against this idea, and it’s worth reviewing some basics here. Even without contraception, fertilized eggs often fail to implant naturally.

It’s not clear why he thinks the fact that embryos often fail to implant naturally has any bearing on whether it is immoral to act purposely to prevent them from doing so, as the owners of Hobby Lobby believe.

He concludes:

Regardless of the data, or lack of it, many still believe that these forms of contraception are different than others. Today, the Supreme Court gave those beliefs weight. This seems likely to make it harder for women to get contraception in the future.

Just how the Supreme Court giving those beliefs “weight” — and precisely what this means given that the Supreme Court did not rule on the content of those beliefs — will result in it becoming harder for women to get contraception in the future we are left to guess at. 

If this is the best empirical case that can be made for an impending crisis in access to birth control, then the Left had better stick to hysterical rhetoric on the subject. 

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