In politics, timing is everything. So despite the fact that the Obama administration announced back in August 2011 that contraceptive counseling and FDA-approved contraceptive methods be included (without cost or co-pay) by employers in new private health plans written on or after August 1, 2012, it's only become a hot button issue now that we're in a volatile election cycle. The rules were put in place last year then clarified and reiterated on January 20, 2012 by the US Department of Health and Human Services, but the debate has intensified in the past week. As of this writing, we're waiting to hear from President Obama in a news conference scheduled just past noon today.
The opposition comes from the bishops of the Catholic Church who insist that contraceptive coverage not be forced on Catholic universities, hospitals, and social service agencies.
Yet as NPR reported this morning, rules requiring contraceptive coverage have been in force for years. On BNPR's health blog Julie Rovner states, "The only truly novel part of the plan is the 'no cost' bit," and includes an audio clip from an ACLU representative who adds "as a legal matter, a constitutional matter, it's completely unremarkable."
As Rovner explains:
In fact, employers have pretty much been required to provide contraceptive coverage as part of their health plans since December 2000. That's when the federal Equal Employment Opportunity Commission ruled that failure to provide such coverage violates the 1978 Pregnancy Discrimination Act. That law is, in turn, an amendment to Title VII of the 1964 Civil Rights Act, which outlaws, among other things, discrimination based on gender.
While the conservative right has framed the argument, casting the move as "a war on religion" in the US, that argument draws attention away from the true issue of women's health care. Including coverage for contraceptives is not the same as forcing an employee to use these methods. It all comes down to individual choice. If health care coverage is truly a "benefit" then that should extend to comprehensive coverage of women's health care needs.
Birth control is a basic fact of most women's reproductive lives, including Catholic women. A number of studies have shown that 98% of Catholics use birth control (in such "artificial" forms as pills, barrier methods, prescription drugs as compared to. the "natural" rhythm method) at some point in their lives. Even conservative NY Times columnist Ross Douthat acknowledges "most studies do show that only 2-3 percent of Catholic couples never use artificial means of birth control" which comes to a sum total of "hundreds of thousands of people."
In Catholicism, as in many other religious faiths, there is individual choice; there will always be practitioners who pick and choose what to believe and follow and what to ignore or discard. Should a handful of bishops or the "hundreds of thousands of people" who are truly faithful control public policy to the point at which others are denied "benefits" extended to the general public?
The sad reality is that it's a tough economy. Having birth control included or excluded from one's benefits package isn't going to be a make or break for a woman grateful to find employment after being out of a job for days, months, even years. But it does ignore the larger social concerns of women and our society. The economic cost of unplanned pregnancy is high, as is the impact on a woman's ability to work and care for an already existing family. With a high divorce rate in this country (another of life's realities frowned upon by the Catholic Church), odds are good that many women with children will become single mothers, and the statistics for this group are disturbing; 1 in 3 single mothers struggle to feed their children.
Denying contraceptive coverage at the same time we cut back on social service programs that provide food and basic support to families in need, we are hurting millions of people in a very real and tangible way, not merely "hundreds of thousands of people" in a theoretical way. If President Obama caves in and makes this exclusion in contraceptive coverage, he does so at our peril.