The contraception debate in a nutshell: There is no contraception debate.
No one—neither Republicans nor the more than 100 individuals and organizations suing over the HHS mandate—is calling for a ban on contraception.
Governor Romney has said that “with regards to contraceptives, of course, Republicans, and myself in particular, recognize that people should have a right to use contraceptives. There’s absolutely no validity whatsoever to the Obama effort to try and bring that up.”
As for religious employers and organizations, they simply don’t want to have their religious beliefs trampled on by being forced to pay for contraception and abortion-inducing drugs in violation of their faith. Heritage legal expert John Malcolm explains that this position “would not preclude any women, including those who work for religious institutions, from using or obtaining contraception or abortifacients. Employers who favor providing contraceptive and abortion drug coverage to their employees would retain their right to do so.”
So now let’s focus on the real issue: Under Obamacare, the government is mandating which benefits an insurer is obligated to cover, and it’s far more than just the infamous contraception and abortion drug mandate. This will have a deleterious effect on health coverage for both women and men.
For instance, Obamacare requires that any recommendations made by the United States Preventive Services Task Force that receive an “A” or “B” rating must be covered by insurers at no cost sharing.
This requirement may have been intended to create a “floor” for covered benefits, but it could have the opposite effect, creating a “ceiling.” The high cost of covering every recommendation will be coupled with higher utilization rates, because no cost sharing is allowed. Under financial pressure, insurers are likely to cover only the preventive services required, leading to the exclusion of services that aren’t rated “A” or “B” by the task force but are nevertheless crucial for specific patients.
Obamacare’s authors may have already conceded that this effect is likely to take place.
In November 2009, the task force updated its 2002 recommendation for all women ages 40 to 49 to receive routine mammograms, lowering it from a “B” to a “C” and changed its recommendation from annual to biennial screenings for women ages 50 to 74. This would make breast cancer screenings for women under 50 a non-required benefit under Obamacare.
Intense controversy followed the change, which led to a unique exception in Obamacare. Section 2713 (a)(5) states that “the current recommendations of the United States Preventive Services Task Force regarding breast cancer screenings, mammography, and prevention shall be considered the most current other than those issued in or around November 2009.” This means that Obamacare mandates insurers to cover the old recommendation (2002) and ignore the current recommendation (2009).
Why include a specific exception if the authors didn’t think insurers might drop coverage for this non-required service?
In a recent New York Post article, Dr. Scott Gottlieb, a fellow at the American Enterprise Institute, listed some of the other benefits that don’t receive an “A” or “B” rating and likely won’t be covered under Obamacare, including cervical cancer screenings in women over 65, teaching breast self-examination, and ovarian cancer screenings.
Prior to Obamacare, task force recommendations were expert advice to help guide doctors and patients. Under Obamacare, it may be the difference between coverage and no coverage.
And finally, because nothing can be too obvious, it must be pointed out that an insurer is not going to charitably pick up the tab for covering birth control or any other new benefit. You will likely pay for it through increased premiums, whether you use the benefit or not.
The bottom line is that this debate is not about contraception; it’s about the horrible health policy contained in Obamacare. As Heritage’s Ed Haislmaier writes, “The new federal benefit requirements represent a blatant assertion that Congress and federal bureaucrats know best how to design health insurance policies. The effects will be one-size-fits-all coverage—so that patients are not ‘confused’ by having choices.”
The contraception and abortion-drug mandate is just a glimpse of what is to come from Obamacare.