For my thoughts on why contraceptive rights support the religious liberty of individuals, see part 1 of this discussion.
Laws that require insurance companies to cover medical requirements, without regard to religious objections, are not the fundamental shift in policy that some political pundits have suggested them to be.
I realize that some readers will say health care is an area of the workplace that is optional, or that the government shouldn’t be meddling in health insurance provided through or in affiliation with an institution. But consider government regulations on other health-related aspects of the workplace. There are requirements in place in regard to lunch breaks, air quality, working space – almost any physical aspect of a workplace you can think of, there’s some sort of government regulation in place. Why these regulations? Why not just let the free market decide? Because, as history has shown, the free market favors those in power. If it’s cheaper to replace a worker than to protect that worker’s life, employers have historically been known to take the financial root over the moral one. And I don’t think very many people are going to argue with me on the point that we need at least some regulation on safety in the workplace (such as not keeping a child in front of a dangerous machine for 12 hours in a row). So it’s not a new thing for the government to regulate workplace health conditions.
But health insurance is complicated – I will give you that. We’re talking about a service provided through the employer (or university), but provided by a third party organization. For many Americans, health insurance companies seem like any other company in the US – and as such something that should be left to the supply-and-demand of the market. But most Americans with that view seem to have secure access to health insurance through an employer. Let me tell you how things changed for me when I lost my health insurance coverage a few months ago (insurance I only kept that long thanks to Obama’s health care bill, which allowed me to keep my mother’s insurance until I turned 26).
When I began looking for health insurance, I discovered that as a private health care seeker, I had no bargaining rights. I couldn’t bargain for a low price by dangling the promise of thousands of customers. I only had myself. And what did the insurance companies want from me? A sure – or nearly sure – gamble. They wanted to do everything they could to discourage me from ever using their money. So, I faced dim prospects. Every plan I viewed included a deductible (ranging from 1k to 10k), and even the plans that provided the most coverage would only help me after I first spent a few thousand dollars on my own – then, and only then, the insurance plans would cover a portion of my additional medical costs. Yes, that would happen quickly if I became deathly ill.
But for someone who just wants preventative care, it would do nothing. A rather silly gamble, if you ask me, since preventative care can save long-term costs for insurance companies. But my point is this – health insurance is so integrally tied to employers, that it’s not even feasible for private buyers to get it on their own, or to cover medical expenses out of pocket. The current system relies on a form of collective bargaining that individuals simply don’t have. So it’s not acceptable to tell women who actually have insurance that they’ll simply have to look elsewhere for any medicine their employer doesn’t condone.
Which brings us to the problem of who’s footing the bill. As you’ll recall, the bill still doesn’t require churches to cover contraceptives through their insurance – there’s already an exemption built in for the religious organization itself. It’s the affiliated organizations (such as hospitals and universities) that really set off the debate. In an attempt to compromise, Obama shifted the responsibility of covering the expense over to the insurance company.
Now, if you’re anything like me, you were probably a tad troubled by the thought of the government requiring the insurance company to pay for contraceptives on their own, instead of building the price into the premium. But here’s why I’m okay with that requirement: the insurance companies will save money because contraceptives provide preventative care for a number of medical conditions. In fact, I think that requirement provides insurance companies with more freedom. Without that mandate, insurance companies would have to agree not to cover contraceptives in order to win the bid for business through the religiously-affiliated employer. Even if they wanted to cover it, there’d be no other way to get business from that institution. As long as insurance companies have the option of dropping medically necessary care on an employer’s moral grounds, they must capitulate in order to win that employer.
Add in the fact that some institutions don’t even subsidize the health insurance they want moral control over, and the question of who’s footing the bill becomes even more relevant – as Sandra Fluke argues (see video above), shouldn’t women who are paying for unsubsidized healthcare have a say in what the insurance company covers? When their doctor prescribes medically necessary care, shouldn’t that take precedence over an affiliated institution’s differing belief system? Shouldn’t these women and their doctors have more say than the associated organization that isn’t even paying a dime toward that insurance?