Reality Check: Birth Control Coverage is Essential to 99% of Women
Mitt Romney’s latest attempt to portray himself as “severely conservative” has him fomenting the attack on new legislation that requires all employers, including religiously-affiliated institutions like universities and hospitals, to provide employees with health insurance coverage for contraceptives. He is certainly not alone among the Republican presidential candidates in condemning this recently-revised rule that now exempts religious employers from having to pay for this benefit, but his words (as they often do…) provide the perfect opportunity for a reality check.
Romney, speaking in a “packed gymnasium” in Colorado told the crowd that “churches and the institutions they run, such as schools and let’s say adoption agencies, hospitals, that they have to provide for their employees, free of charge, contraceptives, morning-after pills — in other words abortive pills and the like at no cost,” Mr. Romney said. “Think what that does to people in faiths without sharing those views. This is a violation of conscience.”
The use of the words “abortive pills” alone is chilling–conflating contraceptive use with abortion has been the purview of the ultra-religious right–but Romney’s assertion that this legislation will violate the conscience of most people of faith is just plain wrong. It will violate the conscience of the small minority of Americans, like Rick Santorum, who, writes Igor Volsky on the Think Progress blog, “has pledged to preach about “the dangers of contraception in this country,’ if elected president.” Santorum is basically opposed to women having sex that is not related to procreation; “It’s not okay,” he has said. “It’s a license to do things in a sexual realm that is counter to how things are supposed to be.” The data strongly suggests that this ship has long since launched.
If you want to know just how pervasive use of contraception is among women of all religions, check out the April 2011 report from the Guttmacher Institute; “Countering Conventional Wisdom: New Evidence on Religion and Contraceptive Use.” It includes the following findings:
“The overwhelming majority of sexually active women of all denominations who do not want to become pregnant are using a contraceptive method. Moreover, 69% are using highly effective methods: sterilization (33%), the pill or another hormonal method (31%), or the IUD (5%).”
The chart below (using Guttmacher data) comes from an aptly titled “reality check” on contraceptive usage posted on the Mother Jones blog:
In at least 26 states insurers who provide coverage for prescription drugs must also provide coverage for FDA-approved prescription contraceptives. Federal law requires that insurers provide contraceptive coverage for federal employees and their dependents (with a handful of religious exemptions). And the Institute of Medicine included contraceptives in their recommendation of essential benefits that should be covered under all health plans available on the state health insurance exchanges. Contraceptives save money by helping women avoid unintentional–and far more expensive–pregnancies; they greatly reduce the need for abortion, and in the case of birth control pills, they are used to treat painful side-effects of menstruation, acne and other medical problems unrelated to preventing pregnancy. The message from many women and their health advocates for at least 30 years is that contraceptives are an integral part of preventive health and should be covered as such.
The effect of the new federal contraceptive legislation is to provide equal access to what has long been determined an essential women’s health benefit. It makes no sense that a woman in Alabama would have to pay between $180 and $600 a year to go on birth control pills (depending on her medical coverage) while it would cost another in New York just a $20 co-pay for the initial doctor visit. Righting these kinds of disparities in essential benefits is one of the underlying goals of health care reform, especially when it comes to prevention and, ultimately, reducing costs. Once again, those claiming the mantle of conservatism are out of touch with the ever-important 99%.
Reforming Health blog 
Naomi–
Yes!
And Catholic women are part of that vast majoirty (98% report having used contraception– at least when they can afford it.)
As one pundit put it on Twitter: “Catholics are not opposed to contraception; old Catholic men (i.e. the Bishops) are opposed to contraception.”
The issue here is not contraception and I am not Catholic or even religious. The issue is whether the Federal government can order a private entity to provide free services.
1. It appears that insurers now must provide “free” services to employees of institutions that object to providing these services themselves. Must they also provide these same “free” services to employees of all other institutions in order to be fair? Surely the institutions whose employees are not getting the “free” services will object to paying while others don’t have to.
2. Insurers are likely to object, never mind the authority issue. Sibelius stated on the News Hour the other night that a year’s worth of birth control pills can cost a woman $600 a year. She declared that to be a burden, but that insurers can provide these same pills for little or no cost because they will save money as pregnancies are averted. The cost of providing pregnancy care is much higher. The difference was not quantified, but there is a built in problem: for the insurer to “save” money, the women receiving the “free” benefit can never get pregnant. If they do, the insurer pays for both the contraceptives and pregnancy care. How therefore does the insurer “save” money on this deal?
3. Apparently alot of hospitals self insure. How do they fit into this process? Seems to me that if they have to provide free contraceptive services then they are being forced to violate their consciences.
4. We have a long history of conscience exemptions: Quakers and objections to military service, Amish and schooling, Christian Scientists and vaccinations, and possibly others. Do we want to continue this tradition, or do we want to stop it right here by requiring those with a conscience objection (religious or not) to providing not merely contraceptives but abortifacient drugs, to violate it? Once you start granting conscience exemptions you can’t say that some are more deserving than others.
Maggie,
Thanks for your comment, it’s always good to hear from you and your point about where the objection to birth control is coming from is very true.
lhf,
I refer you to Maggie’s comment above as to who in the Catholic church is really so morally opposed to birth control. Women, by a large majority, are using birth control and as more and more not only enter the workforce but are providers for their families, they deserve to make the choice as to the size of their families.
And as to conscientious objectors, they are defined by the fact that they make personal, individual choices to refuse to hue to policies or practices they deem objectionable. A Catholic woman who chooses not to use birth control due to religious objections need not do so. But as to whether institutions that employ a large number of employees, many of whom are not Catholic, most of whom have no moral problem with birth control and in fact, desire access to a well-accepted, safe, effective and perfectly legal method of pregnancy prevention–that is not the same as conscientious objection. Making the decision to not provide insurance coverage for contraceptives is punitive, unfair and is actually a clear violation of the division between church and state. Catholic universities and hospitals rely on public money.
If we followed your logic, any business owned by a Jehovah Witness would be able to block coverage for blood transfusions, or if an employer personally objected to vaccines, their insurance policies would exempt coverage for those essential preventive shots.
As to the finances of the deal Obama made, prenatal care and delivery and then coverage of a dependent child adds up to tens of thousands, if not more over the years. Just prenatal care and uncomplicated delivery alone is $6,000 or more. The $600 cost Sebelius was referring to includes an OB/Gyn primary care visit (which is also supposed to be covered without cost once a year), the price of contraceptives varies with type and certainly will never add up to the costs of pregnancy.
I personally believe that the compromise worked out with religious groups–who by the way do not have to provide contraceptive coverage to employees of churches or other houses of worship–might be a stop-gap measure to tamp down the outrage that crops up during election years.
All would have been avoided by separating health care coverage from employment – i.e., a single payer plan. Obama failed to provide leadership on this issue despite coming in to office with a huge supply of political capital.
Once the insurance companies were allowed to keep control, these types of disputes were inevitable and I would argue that a constitutional challenge – not on religious liberty, although that could happen too, but on economic liberty would be viable. I don’t see how the Federal government has the authority to order a private entity to provide free services.
I do agree about the public money. The Catholic charities objecting here should refuse to take it.
The Washington Post gave that Guttmacher Institute study two Pinocchios the other day and dinged the press for passing on misleading information.
The mandate issue is broader than just birth control. The Washington Post published an editorial on February 17th (http://www.washingtonpost.com/opinions/how-health-care-costs-are-taxing-the-middle-class/2012/02/14/gIQAJHFiKR_story.html) about how mandates to provide “free” care result in higher costs to insurance buyers so that insurance companies can provide that care AND make a profit. The writer points out that health insurance stocks rose following passage of the ACA. THe ACA does nothing to control costs – in fact, it looks like a bonanza for the insurers.
Nothing is “free” and the more the notion of free care is promoted the more expensive our medical care will become. Some sort of rationing will have to be imposed and the process is not likely to be pretty.
Thank you for your thoughtful comments on this subject.