Friday, Feb 10, 2012, 12:26 pm
Contraception Compromise: Insurers Take One for the Team
The Obama administration struck an elegant compromise over birth control coverage under health care reform. When religious employers refuse to pay for contraception, their insurance companies will have to step up and cover the cost of birth control for those employees.
The scheme works because birth control saves money. If you were an flinty-eyed insurer, which group would you rather insure? People with guaranteed access to free birth control, or people without? Of course, you'd rather insure the folks with birth control coverage because they're less likely to get pregnant and have babies, which would cost you a lot more than the birth control. You could give away the birth control and still come out ahead.
Of course, just because birth control is relatively cheap doesn't mean it's free. It costs about $21.40 to add birth control pills, IUDs, and other contraceptives to an insurance plan. That money is going to have to come from somewhere.
It's unlikely the insurers will simply eat the cost, and the whole point of the compromise was to avoid passing the cost on to consumers. So, the money will probably come out of premiums paid by everyone (including religious employers) or out of premiums paid by nonreligious employers only.
Already Catholic special interests are objecting to funding contraception out of overall premiums because that means they're funding contraception indirectly. This kind of intransigence illustrates how foolish it was to try to compromise with this constituency in the first place. They are professionally unreasonable.
Compromise is illusory because these guys are doing spiritual accounting, they are not constrained by generally accepted accounting principles. They will make up the rules to get the result they want, namely, "We're being oppressed by your birth control!"
The U.S. Council of Catholic Bishops hates the fact that any woman might get free birth control under health reform. No matter how this program is administered, the sophists at the USCCB will come up with a sob story about how they are being oppressed by our contraception cooties. We live in a highly interdependent society with complex organizations and multiple intersecting streams of public and private money. If you're creative enough, you can always figure out why a dollar somebody else spends on birth control is tainting you.
Covering birth control out of the premiums of non-religious employers means that secular businesses would be subsidizing birth control for workers who aren't on their payrolls, which would be unfair. Why should General Motors pay extra to subsidize insurance for the employees of Catholic hospitals? Remember that health benefits are a form of compensation. Every extra dollar your employer spends on health insurance is a dollar that's not going to your salary. So, utlimately, if only non-religious employers end up paying for birth control, their employees are also taking a hit to indulge the bishops.
If this compromise shuts up the bishops and smooths the way for free birth control, it's worth doing. In the grand scheme of things, it's not very much money. As the employee of secular organizations, I'm okay with subsidizing somebody else's birth control. It's not fair, but unlike the bishops, I'm a pragmatist. The most important thing is getting birth control to people who need it.
But if the bishops won't accept this deal, Obama should stop trying to accomodate them. Respect for religious freedom does not include paying solemn lip service to the contraception cooties.
Lindsay Beyerstein is an award-winning investigative journalist and In These Times staff writer who writes the blog Duly Noted. Her stories have appeared in Newsweek, Salon, Slate, The Nation, Ms. Magazine, and other publications. Her photographs have been published in the Wall Street Journal and the New York Times' City Room. She also blogs at The Hillman Blog (http://www.hillmanfoundation.org/hillmanblog), a publication of the Sidney Hillman Foundation, a non-profit that honors journalism in the public interest.