Arguments in front of the Supreme Court start next week in the Hobby Lobby case. Hobby Lobby is suing for a religious exemption from the Department of Health and Human Services mandate requiring that employer-provided health insurance cover contraception. Most of the coverage of the case has focused on Hobby Lobby’s objection to the contraception itself and how, if the business prevails, its employees will have to pay out of pocket for things like birth control pills or IUDs. But, as Tara Culp-Ressler at ThinkProgress explained on Wednesday, Hobby Lobby and their co-plaintiff, Conestoga Wood Specialties, are also objecting to insurance plans covering “related education and counseling” for contraception. In other words, these for-profit businesses aren’t just asking their female employees to pay for their own contraception, even though they are already paying for their own contraception by paying for their insurance coverage. These companies want to elbow their way into doctor’s offices and call the shots on what doctors can and cannot say to Hobby Lobby and Conestoga Wood employees.
“Essentially, if Hobby Lobby and Conestoga Wood are successful, they’ll win the right to refuse to extend coverage for doctor’s visits that include discussion about certain forms of contraception, like IUDs or the morning after pill,” Culp-Ressler writes. That would probably be something insurance companies could deal with if there was such thing as a specialized doctor’s appointment to only discuss contraception. In the real world, however, most women receive their contraception counseling at general gynecological appointments or annual checkups. You go in, get your blood taken, get a Pap smear, get your breasts squeezed, and then your doctor asks what you use for contraception, and you walk out with a prescription in hand. If Hobby Lobby has its way, by merely acknowledging the birth control pill during that appointment, your doctor would render your entire visit ineligible for coverage by your health care plan.
“This isn’t something that generally is billed separately from a health care visit,” Adam Sonfield, a senior public policy associate for the Guttmacher Institute, explained to me over the phone. “As far as we can tell, the only way to implement this objection would be to say that if your visit is going to be reimbursed by your health care plan, then your doctor can’t talk to you about certain topics your employer objects to.”
It’s unclear if the plaintiffs just haven’t considered how unworkable their ask is, or if marginalizing contraception consultation by making it too fraught to be discussed during a standard doctor’s appointment is the intention here. Either way, it demonstrates how radically intrusive the demands of these companies are. This isn’t just a matter of wanting to “opt out” of paying for a standard service that insurance plans usually cover. This is about giving your employer broad powers to butt into your private business, including micromanaging what you can and cannot discuss with your doctor.