Emily moved from Los Angeles to New York for law school with more health worries than your average 26-year-old. She had lost one ovary to a tumor, had polyps cut from her uterus, and faced a greater risk of developing cancer in her remaining ovary unless she took birth control pills.
When Emily visited the student health services center at Jesuit-run Fordham University, however, she could not get her prescription filled.
The situation facing Emily, who did not want her full name used for privacy reasons, highlights the dilemma at religious-based institutions, which are caught up in the debate over whether health insurance should cover contraception.
On Friday, amid anger from Catholic leaders, President Obama backed away from his vow to mandate that all employers' healthcare plans offer free contraceptive care. Instead, the insurance providers for Catholic institutions will have to "reach out and offer women" such care, a tweak designed to mollify conservatives who oppose birth control on religious grounds.
But 28 states, including New York and California, already mandate that contraception be included in prescription drug coverage. In some of those states, such as New York, Catholic institutions that oppose birth control as a means of preventing pregnancy make it available only for medical purposes.
"That's routine. It happens all the time," said Fordham spokesman Bob Howe.
But Emily and other women at Fordham say it doesn't happen all the time.
At Fordham Law School, fliers advertising an off-campus birth control clinic held last November still hang from some lockers. On the website Collegeconfidential.com, one student accused Fordham of being "backwards and outdated" for limiting birth control. Others argued on the school's behalf. "I always marvel at people who apply to a Catholic Jesuit college and then expect them to change their long-standing policies and Catholic doctrine for them," one person wrote.
Fordham's website describes the institution as "the Jesuit university of New York," and Howe said the school's religious identity is featured prominently in recruiting material. "Our students come to Fordham knowing our Catholic mission and our Catholic identity, and that is central to what Fordham is," he said. "You'd be very hard-pressed to miss it."
Bridgette Dunlap, a Fordham student originally from San Jose, Calif., organized the November clinic to help female students who said they were having problems getting contraception through the school's health insurance. Dunlap said she had heard from several young women with medical conditions that are treated with birth control pills but who had been denied them at Fordham. "What these stories show is that even under a protective mandate, we still can't get affordable birth control," she said.
One second-year law student said she was given painkillers instead of birth control pills, which she had been on since the age of 14 for endometriosis. "I knew you couldn't get a birth control prescription normally, but I knew they supposedly had a health exception," said the student, who would have had to pay $100 to find an out-of-network doctor to get birth control pills.
Other options include visiting off-campus clinics that offer free or discounted care, such as Planned Parenthood, but students say they pay too much for Fordham's health insurance — Emily said it cost her $2,400 a year — to justify having to do that.
In addition, Emily, despite her problems, said she was uneasy going to clinics designed for women with more serious economic problems.
"I'm in a pretty bad spot, but there are so many people in far worse spots," she said.
Emily, like others, notes that Fordham embraces a range of beliefs and lifestyles. Emily herself is a lesbian who has been in a monogamous relationship for years, something she says should show skeptics that her need for birth control is not to prevent pregnancy.
Emily said she hadn't decided what to do but that she had let her birth control prescription lapse and is considering transferring to another law school. The student who was given painkillers is back on birth control, because a friend who is a doctor wrote her a prescription at no charge.
Fordham's Howe said the student health center did not turn away patients who need birth control for medical reasons. "In a minority of cases, students may have to be referred to an outside specialist … but that applies to any medical complaint, not just hormone-related issues," he said.