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Data Note: Differences In Public Opinion On The ACA’s Contraceptive Coverage Requirement, By Gender, Religion, And Political Party

One of the most politically polarizing elements of the Affordable Care Act (ACA) is the law’s requirement that new private health insurance plans cover prescription contraceptives and services, including all methods approved by the Food and Drug Administration. The rule currently provides an exemption for houses of worship and an “accommodation” for religiously affiliated non-profit employers who object to providing contraceptive coverage; however all for-profit employers that provide health insurance must include this benefit. Over forty for-profit corporations have filed lawsuits claiming that the requirement violates their religious rights, and the cases of two corporations, Hobby Lobby and Conestoga Wood Specialties, have reached the Supreme Court. The oral arguments for these cases was heard at the end of March 2014, and in April, over four in ten (44 percent) of the public reported following the news coverage of the oral arguments “very” or “fairly closely.”1 The Supreme Court is expected to announce a decision on these cases in late June. This data note takes a closer look at what the public thinks about this issue.

A majority of the public (58 percent) supports the law’s requirement that private health insurance plans cover the full cost of birth control. On the issue facing the Supreme Court, a somewhat smaller majority (53 percent) believes the contraceptive coverage rule should apply to for-profit companies, even if it violates their owners’ personal religious beliefs, while four in ten (41 percent) say employers that object on religious grounds should not be subject to the requirement, even if it means their female employees will have to pay the cost of birth control themselves. As illustrated in Figure 1, gender and party differences exist on both of these questions, with women more likely to support the requirement than men, and those who identify as Democrats and independents more likely to support it than Republicans.

Figure 1: Support For Contraceptive Requirement By Gender and Political Party
TOTAL GENDER PARTY ID
Men Women Republican Independent Democrat
In general, do you support or oppose the health care law’s requirement that private health insurance plans cover the full cost of birth control?
Support 58% 48% 67% 35% 60% 78%
Oppose 32 41 24 56 31 17
With the exception of certain religious organizations, employers are now required to cover the cost of preventive services including prescription birth control in their health plans. Which comes closer to your view about how this law should apply to for-profit companies whose owners object to birth control on religious grounds?
For-profit companies SHOULD be required to cover birth control in their workers’ health plans, even if it violates their owners’ personal religious beliefs 53% 46% 59% 32% 50% 74%
For-profit companies should NOT be required to cover birth control in their workers’ health plans, even if it means their female employees will have to pay the cost of birth control themselves 41 48 35 66 43 22
NOTE: Don’t Know/ Refused and Neither/ Other (VOL.) responses not shown

Religious identification also plays a role, with support among white Evangelical Protestants much lower than among other groups. Half (50 percent) of white Evangelical Protestants are opposed to the requirement in general, and about two-thirds of this group (68 percent) believe the requirement should not apply to for-profit companies whose owners have religious objections. By contrast, majorities of Catholics, white Mainline Protestants, Protestants who are members of racial and ethnic minority groups, and those who identify with other religions (or no religion) both support the requirement believe it should apply to for-profit companies regardless of their owners objections (Figure 2). Even when controlling for demographic factors, gender, party identification and religious affiliation remain significant predictors of whether an individual supports or opposes the requirement and whether they say it should apply to for-profit companies.

Figure 2: Support For Contraceptive Requirement By Religious Identification
TOTAL RELIGIOUS IDENTIFICATION
White Evangelical White Mainline Protestant Non-White Protestant Catholic Other/None
In general, do you support or oppose the health care law’s requirement that private health insurance plans cover the full cost of birth control?
Support 58% 42% 60% 60% 58% 65%
Oppose 32 50 28 30 33 25
With the exception of certain religious organizations, employers are now required to cover the cost of preventive services including prescription birth control in their health plans. Which comes closer to your view about how this law should apply to for-profit companies whose owners object to birth control on religious grounds?
For-profit companies SHOULD be required to cover birth control in their workers’ health plans, even if it violates their owners’ personal religious beliefs 53% 28% 55% 56% 58% 62%
For-profit companies should NOT be required to cover birth control in their workers’ health plans, even if it means their female employees will have to pay the cost of birth control themselves 41 68 36 39 38 31
NOTE: Don’t Know/ Refused and Neither/ Other (VOL.) responses not shown

Support for the contraceptive coverage requirement also varies by age, and looking at age and gender together illuminates an interesting pattern. Across all age groups, women are consistently more likely than men to support the contraceptive coverage requirement and its application to for-profit companies whose owners have religious objections (Figure 3). While support decreases with age for both men and women, majorities of women in all age groups are supportive of the requirement and believe for-profit companies should abide by it even if their owners have religious objections, while among men, support only reaches above 50 percent for the youngest group (those ages 18-34).

Majority Of Women Support Birth Control Coverage; Younger More Likely To Support Than Older

Figure 3

White Evangelical Protestants, who account for 18 percent of all adults, have some of the highest levels of opposition to the contraceptive coverage requirement; half say they oppose the law’s requirement and nearly seven in ten (68 percent) say that for-profit companies whose owners have religious objections should be exempt. However, white Evangelical Protestant men and women vary in their levels of support. A majority of white Evangelical men (58 percent) say they oppose the requirement, while a slim majority of white Evangelical women (52 percent) say they support it (Figure 4). However, support among white Evangelical women decreases significantly when asked their view about whether the requirement should apply to for-profit companies whose owners have religious objections. On this question, one-third of white Evangelical women (34 percent) believe that for-profit companies should be required to cover birth control, while over six in ten  (63 percent) say they should not be required to cover birth control if their owners object on religious grounds.

Figure 4: Support For Contraceptive Requirement By Gender Among White Evangelical Protestants
AMONG WHITE EVANGELICAL PROTESTANTS
Total Men Women
In general, do you support or oppose the health care law’s requirement that private health insurance plans cover the full cost of birth control?
Support 42% 30% 52%
Oppose 50 58 44
With the exception of certain religious organizations, employers are now required to cover the cost of preventive services including prescription birth control in their health plans. Which comes closer to your view about how this law should apply to for-profit companies whose owners object to birth control on religious grounds?
For-profit companies SHOULD be required to cover birth control in their workers’ health plans, even if it violates their owners’ personal religious beliefs 28% 21% 34%
For-profit companies should NOT be required to cover birth control in their workers’ health plans, even if it means their female employees will have to pay the cost of birth control themselves 68 76 63
NOTE: Don’t Know/ Refused and Neither/ Other (VOL.) responses not shown

Among Catholics, who make up about one in five adults, a majority supports both the contraceptive coverage requirement and its application to for-profit companies whose owners have religious objections. Gender differences within Catholics are again apparent on both questions, with Catholic men being nearly evenly divided on both questions, and about two-thirds of Catholic women in support (Figure 5).

Figure 5: Support For Contraceptive Requirement By Gender Among Catholics
AMONG CATHOLICS
Total Men Women
In general, do you support or oppose the health care law’s requirement that private health insurance plans cover the full cost of birth control?
Support 58% 46% 67%
Oppose 33 46 23
With the exception of certain religious organizations, employers are now required to cover the cost of preventive services including prescription birth control in their health plans. Which comes closer to your view about how this law should apply to for-profit companies whose owners object to birth control on religious grounds?
For-profit companies SHOULD be required to cover birth control in their workers’ health plans, even if it violates their owners’ personal religious beliefs 58% 49% 66%
For-profit companies should NOT be required to cover birth control in their workers’ health plans, even if it means their female employees will have to pay the cost of birth control themselves 38 51 28
NOTE: Don’t Know/ Refused and Neither/ Other (VOL.) responses not shown

Similar to public opinion of the health care law as a whole, opinion about the contraceptive coverage requirement is divided along party affiliation. Republicans are more likely to oppose the requirement (56 percent), Democrats are more likely to support it (78 percent), and independents fall in between (though a solid majority – 60 percent – of independents support it). Across all political identifications, women are more likely than men to support the requirement and more likely to think it should apply to for-profit companies (Figure 6).

Figure 6: Support For Contraceptive Requirement By Party Identification Among Men and Women
TOTAL MEN WOMEN
Rep Ind Dem Rep Ind Dem Rep Ind Dem
In general, do you support or oppose the health care law’s requirement that private health insurance plans cover the full cost of birth control?
Support 35% 60% 78% 24% 50% 72% 46% 70% 83%
Oppose 56 31 17 65 39 24 45 22 10
With the exception of certain religious organizations, employers are now required to cover the cost of preventive services including prescription birth control in their health plans. Which comes closer to your view about how this law should apply to for-profit companies whose owners object to birth control on religious grounds?
For-profit companies SHOULD be required to cover birth control in their workers’ health plans 32% 50% 74% 25% 44% 71% 39% 57% 76%
For-profit companies should NOT be required to cover birth control in their workers’ health plans 66 43 22 72 49 26 59 36 18
NOTE: Don’t Know/ Refused and Neither/ Other (VOL.) responses not shown

Although Republican women are more likely to support the requirement than Republican men, they are still much less likely to support it than independent and Democratic women. In fact, Republican women are one of the only subgroups of women in which support for the contraceptive requirement drops below 50 percent (46 percent support, 45 percent oppose). When asked whether for-profit companies should be required to cover contraception even if their owners object, a smaller share of Republican women (39 percent) say for-profit companies whose owners have religious objections should be required to cover birth control, while 59 percent say these companies should not be subject to the requirement (Figure 7).

Republican Women Divided On Birth Control Requirement; Majority Say It Should Not Apply To For-Profits With Religious Objections

Figure 7

While the majority of adults support the ACA’s contraceptive coverage requirement in private health plans and most feel that it should apply to for-profit employers regardless of owners’ religious views (the question currently being considered by the Supreme Court), there are significant differences between women and men. Support is stronger among women than men, and women’s support holds across age groups, religious beliefs, and political party affiliations, with majorities of most subgroups of women supporting the contraceptive coverage policy and believing the requirement should apply to for-profit companies whose owners have religious objections. Support among men is lower than among women and does not rise above 50 percent for most subgroups of men. However, the importance of party affiliation is evident, as Republican women and Democratic men are notable exceptions to these overall patterns. With public opinion on this topic deeply divided by party, the Supreme Court’s ruling is likely to reignite debate across the political spectrum.