It shouldn’t really come as a surprise that President Obama has decided to extend the exemption for abortion coverage of employees to not just the Catholic Church, but church-affiliated companies. He probably didn’t expect the extent of the protest, and of course he doesn’t want to do anything to jeopardize his re-election.
It’s really not an exemption, either: just an “accommodation.” It’s a small concession that will probably put out the fire that was beginning to start. I wonder whether his allies in the Catholic Church have considered what a second-term Obama, who no longer will have to worry about re-election, would do.
Here’s the way the accommodation would work:
…[O]n Friday, the White House rolled out a new rule, where insurance companies, rather than faith-based agencies, will offer birth-control coverage directly to these employees and foot the bill.
“If a charity, hospital or another organization has an objection to the policy going forward, insurance companies will be required to reach out to directly offer contraceptive care free of charge,” one administration official explained.
This should immediately raise a red flag in any discerning reader: what can they possibly mean when they say “free of charge,” and does anyone believe such a thing possible? I’ll tackle the second question first: yes, some people either think this will be provided out of thin air—or from those supposedly exorbitant insurance company profits or other money that comes solely from someone else.
For the answer to that first question: what the Obama administration means is that the cost will be perceived by the consumer as “free of charge,” and that may be all that matters. At least, they hope that it will be perceived that way.
In fact, that perception is one of the points the entire enterprise of providing “free” contraception or “free” health care counts on. Have you ever noticed that one of the features of government-regulated health insurance is usually the number of services that receive mandatory coverage, some without even requirng co-pays? And simple catastrophic coverage—which many people want, and which certainly would drive health insurance costs down—is not allowed (by the way, an option for more minimal coverage options is one of the things Romney fought for in Massachusetts, and lost to the Massachusetts legislature. But I digress.)
It’s no accident that there is so much mandatory coverage in government-controlled health insurance, because one of the goals is to get people to obtain more preventative health care. Now, I’m not against prevention; “an ounce of prevention” and all that. The question is how to go about encouraging people to get it, and who will be paying for it when they do—with liberals, conservatives, and libertarians falling on their expected sides of the spectrum with their answers (too big an issue to get into in this post, but feel free to talk amongst yourselves in the comments section).
There isn’t much question, however, what Obamacare’s proponents think: their calculation is that, the more a service is perceived as being “free” (or at the very least, pre-paid), the more likely it is to be used. And that this will encourage people to get more preventative care, and to use things like contraception.
It’s a lot like the food on a cruise ship: hey, the meals are already paid for, so why not just chow down? The only difference is that people pay their own cruise fares, and of course one doesn’t usually come off a cruise ship healthier than at the start.
But none of it is really free; it’s factored into the price of the service, whoever foots the bill. So mandatory contraceptives are hardly free, but if they are perceived as such, and getting them incurs no extra charge to the consumer’s pocketbook that he/she can see, the argument is that contraceptives would be more likely to be purchased and used, and therefore more unwanted pregnancies would be prevented.
I’ve already dealt with how much a person would have to pay if purchasing contraceptives out-of-pocket; it actually isn’t all that much, and most working people (the ones we’re talking about here, since we’re discussing employer-offered health insurance) could well afford the cheapest forms of contraception. I also wonder about the basic premise behind the mandatory coverage: how many people actually hold back from using contraception solely because of the expense, and would use it if it were paid for (“free”)? I’ve long been under the impression that the usual reasons for skipping contraception are far more emotional and complex than that. A quick Google search doesn’t really provide the answer, either (although, for example, this list of reasons why teens forego contraceptives doesn’t even include cost as a factor).
As for the question of who would actually be paying for these contraceptives now, if not the Catholic institutions:
It’s difficult to see how insurance companies would avoid using premiums to cover the costs of contraceptives. They could, perhaps, use premiums from non-religious employers. Those businesses wouldn’t likely object on faith-based grounds, but they probably wouldn’t be keen on footing the bill for people who aren’t on their payrolls.
Well, perhaps they wouldn’t be keen on it. But how many people would understand that that’s what’s happening? Most people who might realize that this wouldn’t actually be “free” might not be able to figure out who was really bearing the cost, and the administration would be counting on that.
[NOTE: By the way, that WaPo article I’ve been linking to that explores the catch in the administration’s accommodation is by Ezra Klein. Since I’ve criticized him in the past, I’ll give him his due here; I’m surprised he wrote an article so relatively critical of Obama, but he did.]
