President Barack Obama's decision to require most employers to cover birth control and insurers to offer it at no cost has
created a firestorm of controversy. But the central mandate—that most employers have to cover preventative care for women—
has been law for over a decade. This point has been completely lost in the current controversy, as Republican presidential candidates and social conservatives claim that Obama has launched a war on religious liberty and the Catholic Church.
Despite the longstanding precedent, "no one screamed" until now, said Sara Rosenbaum, a health law expert at George Washington University.
In December 2000, the Equal Employment Opportunity Commission
ruled that companies that provided prescription drugs to their employees but didn't provide birth control were in violation of Title VII of the 1964 Civil Rights Act, which prevents discrimination on the basis of sex. That opinion, which the George W. Bush administration did nothing to alter or withdraw when it took office the next month, is still in effect today—and because it relies on Title VII of the Civil Rights Act, it applies to all employers with 15 or more employees.
Employers that don't offer prescription coverage or don't offer insurance at all are exempt, because they treat men and women equally—but under the EEOC's interpretation of the law, you can't offer other preventative care coverage without offering birth control coverage, too.
"It was, we thought at the time, a fairly straightforward application of Title VII principles," a top former EEOC official who was involved in the decision told
Mother Jones. "All of these plans covered Viagra immediately, without thinking, and they were still declining to cover prescription contraceptives. It's a little bit jaw-dropping to see what is going on now…There was some press at the time but we issued guidances that were far, far more controversial."
"The current freakout," Judy Waxman says, is largely occurring because the EEOC policy "isn't as widely known…and it hasn't been uniformly enforced." But it's still unclear whether Obama's Health and Human Services department will enforce the new rule any more harshly than the old one. The administration has already given organizations a year-long grace period to comply. Asked to explain how the agency would make employers do what it wanted, an HHS official told
Mother Jones that it would "enforce this the same way we enforce everything else in the law."