“It’s very troubling that a salesclerk at Hobby Lobby who needs contraception, which is pretty expensive, is not going to get that service through her employer’s health-care plan because her employer doesn’t think she should be using contraception.”
– Former secretary of state Hillary Rodham Clinton, speaking at the Aspen Ideas Festival, June 30, 2014
A number of readers asked us to examine this statement, on the grounds that it mischaracterized what the owners of the Hobby Lobby arts-and-crafts chain sought as part of their successful case before the Supreme Court. The court ruled 5 to 4 that, as a closely-held company, Hobby Lobby was not required to pay for all of the birth-control procedures mandated by the Affordable Care Act.
Readers also questioned whether Clinton was justified in saying that contraception is “pretty expensive.”
Before the ACA became law, Hobby Lobby actually had provided coverage for all 20 FDA-approved contraceptive procedures required under the law. But once it became a mandate, the owners decided to object to four on religious grounds: Two “morning after” emergency contraceptive pills, Plan B and ella, and hormonal and copper intrauterine devices (IUDs). Founder David Green told the Wall Street Journal he was “shocked” to discover his plan covered these procedures.
“The Green family has no moral objection to the use of 16 of 20 preventive contraceptives required in the mandate, and Hobby Lobby will continue its longstanding practice of covering these preventive contraceptives for its employees,” says a Web site on the case maintained by The Becket Fund for Religious Liberty, which helped bring the lawsuit. “Covering these [morning-after] drugs and [IUD] devices would violate their deeply held religious belief that life begins at the moment of conception, when an egg is fertilized.”
(The majority opinion, written by Justice Samuel Alito, observed in a footnote that the owners regarded these four methods as “causing abortions” but noted that “federal regulations, which define pregnancy as beginning at implantation, do not so classify them.”)
In other words, by broadly defining Hobby Lobby as being against all contraception, Clinton falls into the same trap as Rep. Debbie Wasserman Schultz (D-Fla.), who earlier this year had cited statistics about oral contraceptive pills when discussing the case.
But there is another wrinkle. The court did not rule on whether a closely-held company could object to all forms of contraception on religious grounds. That still needs to be litigated at the lower courts in light of this decision. The Daily Beast counts 82 companies, nonprofit groups and universities that have challenged the contraceptive mandate. Moreover, some closely-held companies are rather large, with tens of thousands of employees.
In other words, while Clinton’s specific reference to Hobby Lobby was inaccurate, the ruling has left unclear whether some employers could institute a broader ban on paying for all contraception. So her statement of concern was not completely off base.
As for “expensive,” this is in the eye of the beholder. Studies have indicated that when times are tough, women have tried to save money by skimping on birth control, such as skipping pills and delaying prescription refills. (Mea culpa: an earlier version of this paragraph rendered Clinton’s quote of “pretty expensive” as “very expensive.”)
Justice Ruth Bader Ginsberg, in her dissent, noted that in the case of IUDs, the devices are “significantly more effective, and significantly more expensive than other contraceptive devices.” She cited a cost of $1,000 for the office visit and insertion procedure — “nearly the equivalent to a month’s full-time pay for workers earning the minimum wage.”
A spokesman for Clinton did not respond to a request for comment.
Update: Some readers have objected to this analysis on the grounds that some women cannot use hormonal contraceptives and thus a copper IUD may be the only safe and reliable form of contraceptive that they can use. Thus, they argue that Clinton could be talking about a salesclerk who faces this particular situation. This is an interesting parsing of her remarks, but given that Clinton’s spokesman choose not to explain her comments, we cannot assume this to be the case. Generally we find that when politicians choose not to explain their remarks, it is because they made a mistake.
The Pinocchio Test
Clinton, who was speaking extemporaneously, should have been more careful in making sweeping statements about the contraceptive coverage at Hobby Lobby. It’s unclear how knowledgeable she was about the details of the decision; host Walter Issacson was a bit sweeping in his description as well.
In the specific case, the company on religious grounds objected to four of 20 possible options, leaving other possible types of contraceptives available to female employees — though not necessarily the most effective or necessary at the moment. It remains to be seen whether the lower courts will interpret the ruling as allowing some companies to institute a broader ban on coverage, so Clinton was leaping to an assumption about the impact on employees.
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