“I was in shock the first time I tried to get my prescription filled as a student, and I was told that I owed seventy-five dollars. I’ve never paid over twenty dollars for it. I was hurt and embarrassed and felt powerless.”
This is the story of one of many anonymous law students, explained in a survey-based memorandum delivered two years ago to the University by the Georgetown chapter of Law Students for Reproductive Justice.
On Feb. 23, Sandra Fluke, a third-year Georgetown law student, testified in front of the House Democratic Steering Committee after being turned away by the Republican-dominated general body. As former president of the Georgetown chapter of LSRJ, Fluke’s testimony was an attempt to shed light on the “financial, emotional and medical burdens” women face when denied contraceptive coverage. She expressed the dire need for birth control for students at religiously-affiliated universities.
Fluke told the story of a friend who suffers from polycystic ovarian syndrome. Rejected by Georgetown’s health insurance plan, this student’s prescription for contraceptives became a matter of life and death. Life for her at Georgetown meant shelling out 100 extra dollars every month, as both her fertility and health required hormone replacement through a daily birth control pill to treat PCOS. Neither her doctor’s verifications nor her own homosexuality was enough to convince the University that her prescription was necessary for purely medical reasons.
Fluke’s testimony has reignited the debate about reproductive justice at Georgetown, where a tradition of Jesuit identity is consistently cited as justification for denying contraception coverage to students and employees.
Her testimony came in the midst of an overwhelming controversy surrounding the Obama administration’s new contraception mandate, which has yet to be implemented as part of the Affordable Care Act. The federal regulation will require all insurance providers to cover free birth control for employees—leaving no exceptions for religiously-affiliated organizations like hospitals, charities, and universities. Two weeks ago, the Senate defeated a Republican measure to reverse the mandate by a very narrow margin.
Shortly after Fluke’s testimony conservative radio talk-show host Rush Limbaugh broadcasted derogatory, personal comments about the law student in a clip where he questioned her motivations for supporting the contraception mandate.
“What does it say about the college coed Susan Fluke [sic], who goes before a congressional committee and essentially says that she must be paid to have sex? What does that make her? It makes her a slut, right? It makes her a prostitute. She wants to be paid to have sex,” Limbaugh said. He also implied that Fluke’s parents should be ashamed to see that their daughter “testifies she’s having so much sex she can’t afford her own birth control pills and she agrees that Obama should provide them, or the Pope.”
Limbaugh’s comments elicited nationwide backlash. On March 2, GEICO, Sleep Train, Legal Zoom, and Citrix Systems pulled their advertisements from Limbaugh’s show. Since then, Fluke has appeared on CNN, Good Morning America, ABC News, and several other major media outlets speaking out against Limbaugh’s remarks. Even Republicans like Senator John McCain (R-AZ) and House Speaker John Boehner (R-OH) have criticized Limbaugh for his language and message. President Obama called Fluke to offer his support, telling her that “her parents should be proud.”
This incident is just the latest episode in LSRJ’s struggle for reproductive justice at Georgetown. For years, Kelly Percival, a leading member of LSRJ, has worked closely with Fluke and other law students to get the University to cover contraception for all students. “This is a battle we inherited,” Percival said.
In March 2010, members of LSRJ sat outside the dining hall for three days with an anonymous survey of questions related to their experiences with the student health plan—particularly with regard to gaining access to contraceptives. The stories they uncovered indicated a broad range of experiences where women struggled to gain access to contraceptives for medical reasons.
“That’s when we found out that a significant number of students have this problem,” Percival said.
On Oct. 7, 2010, LSRJ presented a memorandum based on the results of their survey to the administration on what they called “inadequate reproductive health coverage under the current student health insurance plan.”
In the memorandum, LSRJ cites the survey of 348 Georgetown Law Center students, concluding that 65 percent of students attempting to gain access to birth control for medical reasons were subject to “extensive questioning, inordinate clerical issues, extensive delays, or other complications because of disbelief from doctors and insurance administrators.”
One story in the memo reveals cases of students choosing to lie about medical conditions to continue their prescriptions. For one student, lying has led to even greater problems in her medical care. “When discussing how other medication interacts with my birth control, I am forced to lie and say I am not taking birth control to prevent pregnancy. This may . . . lead to receiving wrong medical advice,” reads the student’s anecdote, quoted in the memo. “Moreover, it is difficult to discuss issues relating to sexual health, especially concerns over sexually transmitted diseases, because I am forced to lie to my doctor about my sexual practices.”
This encourages the type of unethical behavior against which many law students spend their lives fighting. “For professionals who are going to be lawyers…that doesn’t really match up with our future career goals,” Percival said.
After presenting the memo to Georgetown, members of LSRJ met with the Law Center administration in a private meeting to discuss their demands. “They made it very clear to us that they were not willing to change the policy unless there is a legal mandate to do so,” Percival said. “They weren’t really expecting a legal mandate.”
Although the Affordable Care Act will require Georgetown’s insurance plans to cover contraception with no copay, administrators refuse to discuss the matter until its enforcement.
“We offer plans that are consistent with our Jesuit and Catholic identity and mission,” University spokeswoman Stacy Kerr said. “We’re not saying that a student cannot have contraception, we’re saying we offer a plan that does not offer contraceptive coverage unless it’s medically necessitated. But you don’t have to buy our plan.”
On Georgetown’s undergraduate campus, activists confronting the administration have faced a similarly unflinching resolve.
On March 27, undergraduate activists from H*yas for Choice and United Feminists, in part of an action called Plan A: Hoyas for Reproductive Justice, chained themselves to the statue of John Carroll on the front lawn. The duct tape over their mouths read, “President DeGioia: Take the tape off our mouths and the chains off our bodies.” At the time, Heather Brock (COL ‘10), former president of H*yas for Choice, wrote on the Plan A blog that “the message is simple: Georgetown’s policies are chaining us to the past and silencing our ideas.”
The University’s response was unequivocal. Vice President for Student Affairs Todd Olson wrote a letter to leaders of United Feminists and H*yas for Choice, explaining that “Georgetown’s policies and practices rest on the strong underpinning of Catholic social and moral teaching and its affirmation of the dignity of all persons from the beginning of life to its natural end.”
Kristina Mitchell (COL ’10), a central organizer of the Plan A actions and a former member of United Feminists at Georgetown, said the administration took a long time to respond to their demands.
“They seemed very unwilling to reevaluate or rethink [the policy],” Mitchell said. “I know that this is still an issue important to a lot of students, particularly because the people who are being affected by this are on Georgetown’s insurance plan, … people who don’t have any other way to access health insurance, … often people who come from less affluent families.”
Brock asserts that the chaining of students to Carroll’s statue, though drastic, forced the administration to meet with the students. “They refused to meet with us prior to [the action],” she said. “It takes action and sometimes drastic action for the University to listen. That was our goal.”
For years, female student activists speaking up for reproductive justice are asked the same question—what did they expect when enrolling in a Catholic university?
Fluke has a simple response to this question. “We can only answer that we expected women to be treated equally, to not have our school create untenable burdens that impede our academic success. We expected that our schools would live up to the Jesuit creed of ‘cura personalis‘—to care for the whole person—by meeting all of our medical needs.”
Mitchell agrees. “Georgetown is Jesuit, but also says in all its recruiting information that it respects people of all faith backgrounds and different cultural backgrounds,” she said. “We thought that that should mean that people who aren’t Catholic who go to Georgetown should also be able to have access to full health coverage.”
In her testimony, Fluke cited her friend with PCOS who was denied access to contraception for medical reasons because doctors did not believe her story. “Some say my friend’s tragic story is rare. It’s not. I wish it were,” she said to Congress.
However, the University denies the frequency of these cases. “Students are routinely afforded insurance coverage for contraceptive medications when a medical condition is present that necessitates their use,” Kerr said. “Instances where a student has been unable to access contraceptive medications for medical reasons are rare.”
Kerr also insisted that the Student Health Center and the Office of Student Insurance work to “minimize administrative issues for students seeking insurance coverage for oral contraceptives prescribed for medical conditions.”
The Student Health Insurance office at Georgetown declined to comment on contraception coverage in its health plan, the Premier Plan. Currently, the Premier Plan, provided by United HealthCare Company, requires full-time students “to enroll in the most comprehensive student injury and sickness plan offered through the University, unless their other insurance coverage meets specific University requirements.” Law students and undergraduates are covered by the same student insurance policy.
United HealthCare Insurance Company has not released a statement regarding Fluke’s testimony.
The LSRJ memo claims that several other Jesuit universities cover contraception for their law students, such as Boston College, Fordham Law School, and DePaul University. According to a report by the Guttmacher Institute, all of these schools are in states that mandate contraception coverage. However, Massachusetts and Illinois include an exemption that would allow religious universities to opt out of the mandate. Boston College and DePaul University, therefore, provide contraception coverage even though it is not required.
Fluke’s friend is not the only student who has had troubles with medically-mandated contraceptives. Alysse Poppa (COL ’13) also suffers from PCOS, and has been taking oral contraceptives for medical reasons since before she arrived at Georgetown. Upon beginning her freshman year, Poppa brought her normal prescription for birth control to the Georgetown Hospital’s pharmacy, and was rejected. To avoid the lengthy “override” process and prove her medical necessity, she opted out of the student plan. The override process at Georgetown involves providing a doctor’s note or some form of proof that the student has a medical need for birth control.
“How many loops do you have to get through to get your medicine?” she said in an interview. “I see that as being a huge flaw in the system.”
In the LSRJ memo, one student reported a severely delayed process for attaining birth control. “Simply because I am sexually active, the doctor assumed I was lying even though I have medical needs,” the student wrote. “I struggled with getting an ‘override’ because the doctor was hesitant even though I reported severe pain and mood changes that affect my functioning as a student.”
Much like the Plan A activists, Poppa sees reproductive justice as, at least in part, a socioeconomic issue. She strongly believes the financial burden placed on students by the lack of coverage is unjust. “It becomes a debate of, do I want to keep myself healthy? Do I want to eat? When you start having to budget in your medical needs, other things have to fall off your list of priorities,” she said. “Especially for college students, this is not the time that we should be worrying about making ends meet.”
The LSRJ memo paints a similar picture. “Thirty-seven percent of covered women were financially burdened by being required to pay out-of-pocket for birth control that can cost nearly one hundred dollars per month,” it reads. “Over the course of three years of law school, this unreimbursed cost can reach $3000.”
When asked about the University’s response to all the scenarios presented in LSRJ’s memo, Kerr said the University was not prepared to address the issue. “No one has come to us saying, here are 100 women and they haven’t gotten health insurance [for contraception], and they all have the same issues,” she said. “I don’t know, I can’t answer that. It’s a hypothetical that hasn’t been answered.”
However, the Obama mandate continues to fuel LSRJ’s fight. “It’s so important for students, especially for graduate students, because our best option for health insurance is usually the University’s plan,” Percival said. Unlike undergraduates, many law students enter Georgetown no longer being eligible for their parents’ health plans.
In the memo, LSRJ explains that “as a professional school, students at GULC are not differently situated from faculty and staff. Many law students are in their mid-twenties to thirties or older, are married, have children already, or have been using birth control for most of their adult lives.” Three of the four Georgetown faculty healthcare plans do cover contraception, because Georgetown is unable to adjust details of plans that are part of a national pool. According to Kerr, Georgetown provides one contraception-free option to remain consistent with its mission.
Although usually not as financially independent as law students, undergraduates have a large stake in the issue as well.
“We as young adults have choices to make about our lives, and the University shouldn’t take away the safety of those choices,” Brock said.