Some employers who object to President Obama's "contraception mandate" balk at providing birth control of any kind, while others only object to those methods they call tantamount to abortion — underscoring the new health law's thorny ethical questions.
Among dozens of corporations and religious nonprofits that sued over a provision in the Affordable Care Act requiring employers to insure contraceptives, several say they are willing to cover common forms of oral contraception in their health plans. But they draw the line at morning-after pills such as "Plan B" and "Ella," known as "emergency contraception," as an affront to their conscience.
Highlighting the furor around the issue, House Republicans referred to the pills as "abortion-inducing drugs" in rolling out legislation Tuesday that would provide a sweeping exemption for any employer that objects to the mandate on moral or religious grounds.
The debate over covering contraceptives, which may find its way to the Supreme Court, highlights thorny issues surrounding contraception designed to be used after sex, opening the door to cross-claims about reproductive science and when life begins.
In some cases, groups have even been surprised to find out what they've been paying for.
The American Family Association, an evangelical-based nonprofit based in Tupelo, Miss., filed a lawsuit Feb. 20 saying that it is fine with providing coverage for most contraceptives, but that it was shocked to discover in a recent review of its policy that it has been covering emergency contraceptives since 2010.
The group said it opposes drugs "that destroy the human embryo after conception, either after the embryo has been implanted in the uterus or before."
But whether it is even accurate to label the drugs as "abortion-inducing" depends on who you ask, particularly since the interpretation of the drugs' scientific effects is colored by interested parties' definitions of when life begins and their positions on Mr. Obama's health-care bill.
"While individuals are entitled to their religious beliefs about when life begins, as a scientific matter, emergency contraception does not disrupt an established pregnancy," said Brigitte Amiri, a senior staff attorney at the American Civil Liberties Union who has filed briefs in support of the mandate. "Therefore, medically speaking, emergency contraception is not the same as abortion."
Conversely, Biola University nursing professor Susan Elliott said that while Plan B and Ella work differently — with the latter considered closer to the abortion-causing claim — there is a scientific reason to assert the drugs' effects amount to abortion.
"What is left out a lot is [that the drug] actually irritates the lining of the uterus, the endometrium. So you can have a fertilized egg, but then it gets to a hostile environment," Ms. Elliott said.
She joined three House Republicans — Reps. Diane Black of Tennessee, Jeff Fortenberry of Nebraska, and John Fleming of Louisiana — who on Tuesday introduced the Health Care Conscience Rights Act.
The lawmakers said the contraceptive mandate reneges on promises Mr. Obama made to keep abortion services out of his signature health law — a compromise that pro-life Democrats such as former Rep. Bart Stupak of Michigan sought as the president culled crucial votes for his reforms.
"In fact, that's how it got passed in the House," Mr. Fleming said. "Otherwise, it wouldn't have passed."
He said the bottom-line is that objectors should be able to follow their consciences, no matter the form of contraception.
"This is not a negotiation between people and their conscience and the government," Mr. Fleming said in a brief interview. "This should be completely carved out, and we should be able to do what we want."
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