Birth Control was always a point of contention. Facing numerous failures to execute one large sweeping rebuke of President Obama and his most important legacy, the Patient Protection and Affordable Care Act (Obamacare), the Trump administration continues its smaller scale attacks of sabotage, subterfuge, and repeal by executive fiat. President Trump’s latest victim is the coverage for Birth Control Pills, IUD’s, and the Morning After Pill.
This blog has detailed Obamacare’s numerous battles to provide no-cost reproductive coverage for women. Making this a part of the Preventive Care Benefit, FREE and available to just about everyone, intensified the fight. And let us be clear, this was a fight Secretary of Health and Human Services Kathleen Sebelius wanted. Though a majority of American women may favor and utilize some form of contraception such as Birth Control Pills, the addition of IUD’s and the Morning After Pill guaranteed that powerful forces would never settle for anything less than the total elimination of this benefit.
Trump gave them what they wanted this past Friday.
Before we go any further, let us first address the accessibility of Birth Control. Under the PPACA the pills, or at least many versions, are FREE. With Birth Control Pills being lumped in with the Preventive Care Benefit, both the cost and the stigma associated with contraception was eliminated. And though many organizations will now eliminate the benefit under either religious or moral grounds, Birth Control Pill will still be prescribed to their employees and may still be covered. We will just revert to the way it used to be. Young women will parade into their doctors’ offices complaining of menstrual issues and the doctors will prescribe the Pill to regulate their cycles. The medication will be covered, just not free, so that we will also be back where access to contraception was as much a class issue as it was religious. Can the employers remove this medication completely from their lists of covered meds? In some instances, perhaps. I sure wouldn’t want to be the HR manager that had to explain this to the mother of a distraught 15 year old.
All health policies force us to pay for certain medications and/or procedures that we, personally, couldn’t or wouldn’t use. A single, never married, male never encountered any of the claims associated with pregnancy or menopause. My prostate cancer claims were paid with the premiums of men AND women. We are all in this together. You might find the concept of organ transplants for adults over 50 as an unnecessary luxury, a cost that should be borne by the organ recipient. Perhaps, but that isn’t how our system works. We don’t take a poll to see which health issues you choose to cover. Here we spread the risks amongst as many people as possible.
There are organizations that are applauding this latest executive action. And since it was broken into two parts (religious organizations and those with a moral objection), at least part of Friday’s order may survive a court challenge. I view it as another step towards separating health insurance, the way we access and pay for healthcare, from employment. I certainly understand why the Catholic Church didn’t want to pay for Birth Control Pills for nuns (They were exempted), but do you want to be forced to ask about the Pill when you are applying for a job at a machine shop? Where, exactly, does the line get drawn?
I have insured churches and synagogues. I have insured the deeply religious and the ritualistically observant of many faiths. My clients, in almost every case, simply chose to forego those benefits that they deemed inappropriate. They didn’t try to impose their deeply help values on the rest of society.
On Friday the Trump administration scored a small victory. One hundred thousand women and/or their daughters may be forced to pay for Birth Control Pills. Some will. Some won’t. We won’t know for about five years if this leads to more unplanned pregnancies, unwanted children, and abortions. But right now the thing to remember is that Donald Trump scored a small victory.
Break out the Champagne!
Picture – “Time to Dedicate Another Trophy” by David L Cunix