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Where Do We Draw the Line?

By Emma Bittner

TWHC has begun collaborating with Coalition members to hear more about the topics that move and inspire them. In the first installment, we’ll hear from Emma Bittner, a Young Advocate and University of Texas at Austin student, about her thoughts on the Affordable Care Act’s (ACA) contraception provision and how the United States Supreme Court decision stands to affect her and others.

It's no secret that the Affordable Care Act (ACA) made huge strides for women. I was only ten when mammograms, well-woman visits, breastfeeding support, cervical cancer screenings and other preventive services became free, and the ACA reduced sex discrimination in health coverage as women could no longer be charged higher premiums. I grew up watching reproductive health become more and more accessible. While the ACA had taken leaps forward for healthcare, dismantling it is quickly moving us backwards.


Since the ACA took effect, we’ve seen the birth control mandate challenged multiple times, but recent legal arguments made, claiming employers who have a religious or moral objection should be exempt from providing coverage for contraception, are keeping women on edge.


While some people are uncomfortable with the reality of women taking birth control as a part of their sexual health routine, women should not be reprimanded for doing the right thing for their health and future. It’s important to emphasize that birth control’s main purpose may be to prevent unintended pregnancy, but that isn’t its only purpose. It’s prescribed to reduce acne, treat migraines, cramps, endometriosis, and prevent and reduce the risk of ovarian cysts. No matter the reason women utilize a Federal Drug Administration (FDA)-approved method of contraception, they shouldn't be penalized for it.


I’ve been on birth control for years to help mitigate painful cramps and treat ovarian cysts. While it’s common for the women in my family to use birth control to help treat extremely painful periods and cysts, I didn’t realize my day to day life would rely on it so heavily. If my birth control was no longer covered by my insurance, I don’t know that I would be able to afford it, which would leave me with a whole new world of problems.


As a full-time student at the University of Texas at Austin – who balances classes, internships and a part-time job – I simply don’t have time to deal with the side effects that my birth control manages. Without birth control, debilitating pain would resurface as a common part of my life. I would miss class, work, and other activities that require my presence, time, and attention.

On the evening of July 7, I went through my bedtime routine. I poured some tea, watched a movie, and took my birth control. On July 8, I woke up in a panic. In a 7-2 split decision the U.S. Supreme Court decided that employers could use moral or religious objections to opt out of offering birth control coverage in their employee healthcare plans.


I was stunned. The understanding that so many women were about to lose access to a critical part of their life and reproductive healthcare, left me bubbling with fear and anxiety. While this reality is not one I’m likely to have to face because of my privilege, many women aren’t as lucky as me. Soon employers would be able to opt out of the birth control coverage provided in employee healthcare plans.


The women affected will now have to seek alternative methods to obtaining birth control and will – once again – have to pay out of pocket for contraceptive services. Broadening of the scope of employer exemptions from covering birth control in their employee provided health insurance plans has several implications.


The New York Times reported that 70,000 to 125,000 women could lose contraceptive coverage. This could result in an increase of unplanned pregnancies, and in a country that ranks last place among developed nations in maternal mortality rates – with about 700 women dying every year according to the Center for Disease Control – we could see those rates increase if more women lose contraceptive access.


According to the Center for Disease Control, Black women were 2.5 times more likely to die of childbirth complications than white women in 2018. Removing access to birth control impacts all women, but Black women would be impacted at a much higher rate with potentially life and death consequences.


Birth control coverage is more than providing affordable contraceptives, it is about leveling the playing field and promoting gender equity.


No matter the reasons we use birth control, it’s not anyone’s concern outside ourselves. I watched contraception become covered under the ACA when I was 10 years old, I thought the issues my mom and grandma faced were in the past. Just as I watched reproductive healthcare become more accessible, I’ve also watched it be slowly eroded. Women shouldn’t have to worry about access to contraception. If we do, then our lives as we know it will change, leaving us to deal with the extremely treatable and unnecessary health consequences.


Emma Bittner is a student at the University of Texas at Austin studying Journalism and Communication & Leadership. She is also a Young Advocate with Young Invincibles. Young Invincibles is a national, nonprofit organization committed to elevating the voices of young adults in the political process and expanding economic opportunities for 18 to 34-year-olds.


If you’re a TWHC member and your organization is interested in sharing your insights on a topic related to women’s healthcare, contact Advocacy Communications Specialist, Perdita Henry, at phenry(@)TexasWHC(dot)org for more information.

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The Texas Women's Healthcare Coalition is a project of Healthy Futures of Texas, a 501(c)(3) non-profit based in San Antonio.

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