The totally confused contraception debate

I have been following the contraception mandate debate in the United States, and am somewhat amazed by how unrelated the discussion is to what the new contraception rule actually requires. The rule does not require religious employers to provide contraception coverage for their employees. Despite this, the usual suspects on the right-wing and even Pew polling have been participating in a debate about whether requiring religious employers to provide contraception coverage is the right thing to do.

Here is what the new contraception rule requires. Non-religious employers must provide health insurance plans that cover employee contraception. Religious employers can opt out of such plans entirely, and if they do so, the insurer will be forbidden from charging more than they would for a non-contraception plan. Outside of the religious employer, the insurance company will be made to contact employees directly and offer them free contraception coverage.

So the question becomes: what exactly is the objection here? Generally, one might say that someone somewhere will have to foot the bill for the free contraception side plan: if not the religious employers, then other people insured by the same company. But the unique thing about contraception coverage is that it pays for itself through reducing unplanned pregnancies which are much more costly. So, there is no additional cost springing up elsewhere that someone is secretly paying.

The only other possible objection then is that the religious employers do not want to pay in dollars that may eventually find themselves being exchanged for contraception. But when you get to this level of objection, it becomes so abstract and confusing as to be meaningless. You cannot actually determine what any given dollar does or does not go to when you pay it into a giant insurance pot. Money is fungible and there is no such thing as “your dollars” once it goes into the insurer’s account. If there is something objectionable about paying dollars into any entity that then pays dollars out for contraception, then buying into insurance at all is a problem. Even if your insurance plan does not cover contraception, it is almost certain that the insurer offers plans to someone else that does include that coverage, meaning the dollars are already going into a pot of money that partially gets used to buy birth control pills.

More than that, anyone who pays federal taxes is already involved in sending money into an entity that directs some of it into buying contraception. There is nothing unique or novel about doing it again for insurance.

Of course, we know the debate is just some sort of culture war wedge issue manufactured to stir up controversy of various sorts. But it is one the flimsiest and most misleading debates I have ever seen. There is no contraception mandate for religious employers. The free contraception side plans will not cost anyone anything. And any objections about having to pay into a pot of money that buys some contraception — an objection I have not actually seen articulated by anyone — is totally non-unique since all religious employers with insurance already do this. Sadly enough, this issue has been so misconstrued and misrepresented that even liberals are trying to defend the contraception mandate instead of pointing out that there is no such mandate.

Economic injustice continues to plague women

I have another post on Oklahomans for Reproductive Justice. Check it out. Here is an excerpt:

By themselves, poverty and the wage gap create significant barriers for women trying to obtain reproductive healthcare services. These barriers are made even stronger by the fact that women’s healthcare needs cost more than men’s healthcare needs, especially in the realm of reproduction. Paying women less money than men — so little in millions of cases that they must live in poverty — while also charging them more for healthcare access is an obvious problem. But it gets even worse: nearly 1 in 5 women have no health insurance at all.

Even if organizers manage to keep access to reproductive healthcare legal in Oklahoma, it will not be genuinely accessible for large numbers women until we also eradicate the economic injustice that continues to plague women. High rates of poverty, the wage gap, higher healthcare costs, and the lack of health insurance — all of which affect certain women of color at vastly disproportionate levels — will guarantee the inaccessibility of reproductive healthcare in any legal climate.

The contraceptive debate and our dysfunctional healthcare system

I have another article over at Oklahomans for Reproductive Justice:

Implementing a universal healthcare system — such as the single-payer system used in Canada — would remove employers from the healthcare game altogether. Under such a system, individuals would be covered directly as individuals, not as employees. This would get religious employers out of the business of paying for insurance, and thus keep them from being vaguely close to paying for contraception too. This benefit would be in addition to all of the normal benefits attributed to such a system: it contains costs better, covers absolutely everyone, and delivers care more efficiently.

As it stands however, the dysfunctional and costly system we have in place appears poised to remain for some time, making these employer contraception rules very important for those interested in reproductive justice. Although it would have been better if the Obama administration had held strongly to its January 20th rule that rejected religious exemptions to contraception coverage, the compromise is not so bad either. If the administration does not compromise further, this new rule ensures that all employees covered by employer-provided health insurance will have free access to contraception one way or another. That is definitely progress even if somewhat muted.

Matthew Yglesias’ post yesterday about this debate is also highly recommended.