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Duly Noted

Monday, Mar 5, 2012, 1:19 pm

Birth Control Coverage is Not About Religious Liberty

By Lindsay Beyerstein

Rush Limbaugh's recent outbursts and fingers-crossed apology to Georgetown law student Sandra Fluke have satisfied most people that "religious liberty" arguments against the birth control mandate are just a figleaf for Republican misogyny.

But if you're still not convinced, let's take a closer look at the religious liberty argument. I'll show you why this special pleading is specious.

The Affordable Care Act gives insurance companies a license to print money: Millions of Americans will have to buy their product, and some will even receive public subsidies to do so--all with no competition from a pesky public option.

In exchange, the government gets to set ground rules for what the insurance will cover.  The ACA has all kinds of rules about minimally acceptable coverage. An insurer can't just say, "Sorry, this policy doesn't cover any cancer treatments at all. You have to get a separate cancer policy." That would be crap insurance and it wouldn't be fair to force anyone to buy it, let alone to spend tax dollars to subsidize it.

By the same token, birth control is a basic part of health care, so it should be part of every health insurance policy. Otherwise, the American people won't be getting their money's worth. The Obama administration has already offered to have insurers pay for birth control where religiously-affiliated institutions are squeamish about paying for it themselves, but these institutions aren't satisfied.

The standards for minimally adequate insurance are hashed out between the government and the insurers, on behalf of the policy-holders and the general public. After all, the most important goal of health reform was to get everyone covered by decent insurance. 

It is none of the employers' business what a minimally adequate health insurance policy covers. That's a public policy question, not an HR decision. An employer can choose to cover more than the minimum, but the minimum is non-negotiable.

If an employer is going to offer you a company car as a benefit, she doesn't get to decide what the safety specs are for that car. That's between the government and the car manufacturer on behalf of the consumer. By the same token, if an employer is going to offer you health insurance at all, that insurance has to meet the minimum standards.

When the Affordable Care Act goes into full effect, employers with at least 50 employees will have a choice. They can either offer qualified health insurance or they can pay a tax of $2000 per employee. If a large religious institution doesn't want to offer health insurance to its workers, for whatever reason, it can simply pay up. Religious liberty does not require the government to give religious institutions a pass on offering substandard insurance.

A president of a Catholic university told the Washington Post that he was considering cancelling all health coverage for his employees if the birth control mandate didn't go away.

Religious institutions don't really want to stop offering health insurance. Insurance is an important tool for recruiting and retaining talent. For various tax and actuarial reasons, it's cheaper for an employer to buy insurance for employees as part of a group than for employees to buy the same coverage individually.

So, if a Catholic university wants to attract the same caliber of employees without offering health insurance, it will have to spend much more on raises than it would have spent on health insurance premiums, in addition to the $2000/worker fee.

If they don't want anything to do with insurance, religious organizations are free to jettison the whole enterprise. They can pay the same fees as any other opt-out employer, no questions asked. Then they can pay what it costs to attract quality employees in the job market.

That's religious liberty. Nobody said following your conscience was cheap. 

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.

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