Unicorn Birth Control Coverage: The Myth Behind Zubik v. Burwell

I know what you are thinking: Unicorn birth control?! Is that a thing? No, it is not. (Although unicorn birth control cases do exist.)

I’m using the term “unicorn” here to refer to an idea that is fantastical and mythical. And it is the perfect term to describe the latest ideas that opponents of the birth control benefit have proposed to the Supreme Court.

60-Second Recap

Zubik v. Burwell is a case pending before the Supreme Court that will determine whether or not bosses can — once and for all — use their religious beliefs to deny their employees access to birth control coverage.

Here’s how coverage works right now:

• Federal law requires almost all health insurance plans to cover birth control without a copay, but it recognizes that certain employers may have religious objection to birth control.

• The law permits those employers to eliminate coverage of birth control from their employer-sponsored health insurance plans.

• To make sure women can still access birth control, health insurance companies are required to directly provide employees birth control with no copay.

• This workaround system (“accommodation”) guarantees that employers do not have to pay for services to which they object, while still ensuring that women get access to no-copay birth control.

Sounds ironclad, right? You’d think so, but the employers in Zubik v. Burwell are challenging that workaround. They claim that having to complete a simple form (or send a letter to the Department of Health and Human Services) certifying their religious objection to birth control substantially burdens their religious beliefs.

If they win, they will be able to skirt a legal requirement of the Affordable Care Act — and women who work for those employers will lose access to health insurance that covers birth control entirely.

What’s New

The Supreme Court issued an order that asked both sides (the employers and the federal government) to answer whether there could be an alternative to the existing workaround. 

Specifically, the Court asked whether health insurance companies could provide employees no-copay contraceptive coverage without employers having to provide the existing required notice.

The Big Unicorn in the Room

The employers claim there is an alternative to the current birth control coverage workaround. They propose to rework the entire health insurance system by having insurance companies offer health plans that only cover contraception. Women would separately enroll in these contraception-only plans to get birth control, meaning they would have to have multiple health plans (a little weird, right?).

Here’s the kicker: Contraception-only plans do not exist in reality — which means that their purported alternative process will not actually provide women seamless access to birth control, or access to birth control at all.

Their proposal is nothing more than a unicorn. It may look and sound cool to some people — but it is, in fact, make believe.

The Obama administration specifically designed the existing birth control workaround to make sure individuals have a seamless coverage experience. Under the current system, employees and students automatically have access to no-copay birth control. There is no need to separately enroll in a different health plan (that is yet to exist) by a certain deadline, carry another insurance card, or to find a provider who actually takes that insurance to access birth control.

Federal policy currently ensures that no matter where you work or go to school, you can get no-cost birth control. The Affordable Care Act recognized that women’s health care is exactly that — health care — and required plans to cover birth control, as well as other preventive care, without cost to those insured. In 2016, women should not have to specifically seek out a separate, supplemental health plan that covers birth control.

As we have said before, this case is not about religious freedom. It is about limiting women’s access to health care.

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Davida Silverman is a Senior Policy Analyst at Planned Parenthood Federation of America. She uses her expertise in health care policy to advocate for policies that enable individuals to obtain quality reproductive health care at Planned Parenthood and other women’s health providers.  

Learn More About Zubik v. Burwell

Bosses say that having to complete a simple form certifying their religious objection to birth control "substantially burdens" them. So, instead they propose something that totally burdens everybody else.

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Tags: Obamacare, Supreme Court, birth control