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EC Research Counters Claims in Supreme Court Cases; Polls Show Most Support Birth Control Coverage

EC Research Counters Claims in Supreme Court Cases; Polls Show Most Support Birth Control Coverage

November 27, 2013 — A change by European regulators to the label of an emergency contraceptive contradicts claims by private companies challenging the federal contraceptive coverage rules before the Supreme Court, the New York Times reports (Belluck, New York Times, 11/26).

The high court announced Tuesday that it would hear two cases -- one involving the arts-and-crafts retailer Hobby Lobby and one from cabinet maker Conestoga Wood Specialties -- that confront whether corporations can exercise religious rights. Both cases claim violations of the 1993 Religious Freedom Restoration Act (PL 103-141), which states that the government cannot impose a "substantial burden on a person's exercise of religion," unless the burden serves "a compelling governmental interest" and is also "the least restrictive means" of doing so. The Conestoga case also cites the First Amendment's guarantee of free exercise of religion (Denniston, SCOTUSblog, 11/26).

According to the Times, the plaintiffs' religious objection to offering their employees contraceptive coverage is rooted in their opposition to EC. They claim that the drugs can prevent a fertilized egg from implanting in the uterus, which they believe is tantamount to an abortion.

However, European health authorities have altered the label of the EC product Norlevo to say that the drug "cannot stop a fertilized egg from attaching to the womb." Although Norlevo is not available in the U.S., Plan B One-Step and two generic versions that are available in the U.S. are identical to it. The new Norlevo label also warns that the drug loses effectiveness in women weighing more than 165 pounds.

U.S. Implications

The labels of the U.S. EC pills, which all contain the drug levonorgestrel, state that they work mostly by preventing ovulation, but they also say the drugs might inhibit fertilized eggs from implanting in the uterus.

The Times last year detailed studies providing strong evidence that levonorgestrel cannot prevent implantation. Later, NIH and the Mayo Clinic removed references to blocking implantation from their websites, and FDA spokesperson Erica Jefferson said that "the emerging data on Plan B suggest that it does not inhibit implantation."

On Tuesday, Jefferson reiterated that view. However, the agency has not yet moved to change the labels of the U.S. ECs, saying that the drugmakers need to request the change.

Plan B One-Step manufacturer Teva Pharmaceuticals declined to comment. It has said before that scientific evidence suggests the pill cannot interfere with implantation (New York Times, 11/26).

Polls: Most U.S. Residents Support Contraceptive Coverage

In related news, public opinion polls show that most Americans support the contraceptive coverage requirement, including on the specific issue of whether secular corporations should have to offer the coverage, according to the Washington Post's "The Fix."

A March 2012 Public Religion Research Institute survey found that U.S. residents "overwhelmingly" supported the requirement for publicly held organizations, by a 62% to 33% margin, "The Fix" reports.

In addition, 53% said privately owned, small businesses should be required to offer contraceptive coverage in their health plans at no cost to beneficiaries, while about 43% said such companies should not.

A separate Washington Post-ABC News poll from March 2012 found that while U.S. residents are less supportive of requiring places of worship -- which are exempted from the rules -- to cover contraceptives, they "broadly favored" the idea that insurance companies be required to provide such coverage at no cost for women. The poll found 61% agreed with the requirement, while 35% opposed it (Sullivan/Clement, "The Fix," Washington Post, 11/26).