The Religious and Moral Exemption Rules: Increasing Systemic Barriers for Women of Color

Since the passage of the Affordable Care Act, over 15 million women of color have gained health insurance with coverage for preventive services, including no-cost contraceptives. Affordable access to contraception is critical and allows women of color to plan their lives and families, and in turn to secure health and economic stability for themselves and their families. However, this Administration has aggressively sought to dismantle this progress. In November 2018, the Departments of Health and Human Services, Labor, and Treasury issued two rules, the Religious Exemption Rule and Moral Exemption Rule, that broadly exempt nearly every employer or university with a religious or moral objection from providing comprehensive coverage for preventative health services, as required by the Affordable Care Act. If enacted, the rules will deprive thousands of women meaningful access to contraceptive health care services secured by the Affordable Care Act and disproportionately harm women of color and low-income women who already face heightened disparities in their reproductive rights.

Yesterday, the Lawyers’ Committee and the Center for Reproductive Rights, together with a coalition of civil rights organizations, filed an amicus brief in the Ninth Circuit highlighting how the rules disproportionately impact women of color and low-income women, who already face systemic, intersectional barriers in exercising their reproductive rights and access to adequate health care services. For instance, women of color, including Black, Latina, Asian, and Pacific Islander women, are more likely to earn lower wages and less likely to have health care coverage and afford out-of-pocket health care costs, disparities that the Affordable Care Act has helped to alleviate since its passage.

Despite statistics showing that women of color are entering the workforce at increased rates, Black, Latina, and Asian women continue to be over-represented in low-wage jobs, which perpetuates both poverty and low rates of health care coverage among women of color. Additionally, women of color in low-wage jobs face increasing economic burdens with childbearing and motherhood, which place unique constraints on financial stability, wages, labor force participation, and occupational status. Research shows that women sustain economic drawbacks for having children, with a four percent decrease in earnings for having one child and a twelve percent decrease for having two children or more. Because Black and Latina women already suffer under severe pay disparities, any time spent out of employment exacerbates these preexisting wage gaps in relation to men.

On top of these pervasive wage disparities, contraception fees pose another economic burden for low-income women and women of color. The costs for oral contraceptives, the most popular form of birth control, averages out to $850 per year without insurance. For long-term contraceptive methods, such as IUDs and implants, out-of-pocket costs can exceed $1,000. Research shows that these up-front costs are disproportionately unaffordable for many women of color. In 2017, a survey found that 39 percent of African-American women between 18 and 44 are unable to afford more than $10 per month for birth control. Another survey found that 57 percent of Latinas between 18 and 34 had struggled to afford birth control before the Affordable Care Act.

Unnecessary and discriminatory barriers to affordable contraception harm communities of color and exacerbate economic inequality. The Lawyers’ Committee for Civil Rights Under Law will continue to challenge systemic infringements on the reproductive rights of women of color in the courts.