NORMAN — Supreme Court Justice Sonia Sotomayor made a reasonable decision when, on New Year’s Eve, she temporarily blocked implementation of the Affordable Care Act’s contraception coverage mandate in a case brought by a religious order of nuns that operates homes for the poor and elderly in Catonsville, Md., and elsewhere. It certainly doesn’t hurt to wait a few days and hear the government’s argument for immediate implementation. But the 11th hour drama doesn’t change the fact that the contraceptive coverage requirement is good policy, and the mechanism for groups like the Little Sisters of the Poor to avoid violating their religious tenets is reasonable.
Birth-control pills are often used for medical reasons that have nothing to do with preventing pregnancy. It would make no sense for women who use them, for example, to treat endometriosis to be forced to pay more for them than another drug. Moreover, the cost of unplanned pregnancy on society as a whole and the health-care system in particular is enormous. Two years ago, the Guttmacher Institute, which advocates for reproductive health and rights, estimated that the cost to taxpayers was more than $11 billion annually. Making birth control as readily available as possible is unquestionably a good investment for the health-care system. That’s why the Institute of Medicine recommended that it be included in the preventive care coverage of the Affordable Care Act in the first place.
Religious employers like churches are exempt from the contraceptive coverage requirement, and they always have been. For-profit companies whose owners object on religious grounds to contraception are not exempt, though that issue is headed for the Supreme Court via a pair of unrelated lawsuits. Non-profits that are affiliated with religious institutions fall into a third category that allows an avenue for avoiding the requirement while still giving lay employees access to birth control.