The Magazine

The High Price of ‘Free’ Health Care

Mar 12, 2012, Vol. 17, No. 25 • By JOHN MCCORMACK
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Today, in the United States, the federal government does not force insurers to provide free contraception. Yet contraception is as widely available as it is cheap. Most insurance policies cover it. The federal government gives birth control to the poor through Medicaid. The federal government spends an additional $300 million per year to provide it to low-income and uninsured Americans who don’t qualify for Medicaid​—​spending that the staunchest conservatives in Congress supported even when Republicans controlled the presidency, the Senate, and the House. If a middle- or upper-income woman happens to be in one of the small number of plans that don’t cover contraception​—​say, an employee at a college run by Catholic nuns​—​she can buy birth control pills for as little as $9 per month at Target.

Photo of President Barack Obama and HHS Secretary Kathleen Sebelius

President Barack Obama and HHS Secretary Kathleen Sebelius

AP IMAGES / Orlin Wagner

Yet by the logic of the Obama campaign and many Democrats in the House and Senate, the current policy amounts to a “ban” on contraception. And the federal government can only right this injustice by forcing private insurers​—​including insurers of religious institutions​—​to provide free contraception, as well as free drugs that can induce abortions early in pregnancy.

“Let’s admit what this debate is really and what Republicans really want to take away from American women. It is contraception,” New York Democrat Chuck Schumer said on the Senate floor. He said Republicans were trying to enact a “contraception ban” that would send the country back to the “19th century.” Not to be outdone, Democratic senator Frank Lautenberg of New Jersey said that Republicans want to take us back to “the Dark Ages .  .  . when women were property that you could easily control, trade even if you wanted to.”

The Obama campaign claimed that Republicans effectively wanted to force women to get a “permission slip” from their employers to “access birth control pills, intrauterine devices, or any other type of contraception.” Obama’s deputy campaign manager wrote in an email to supporters: “If you’re a woman, who do you think should have control over your choice to use contraception: You or your employer?” The New York Times and others in the mainstream press reported Republicans were backing a measure to allow employers to “deny coverage” for contraception, mimicking the Democrats in substance if not in style.

Of course, the bill the Obama campaign and friends were demagoguing wouldn’t have denied anyone access to birth control. The amendment, sponsored in the Senate by Republican Roy Blunt of Missouri and Democrat Ben Nelson of Nebraska, would merely let private employers or insurers opt out of Obama-care’s benefits mandates for moral or religious reasons​—​taking the country all the way back to .  .  . 2012. Americans currently have this right​—​the mandate doesn’t take effect until August for most employers and next year for religious institutions.

The conscience protections in the Blunt-Nelson bill are identical to the protections included in many federal health care laws on the books and even the 1994 Clinton reform that never became law. The bill wouldn’t affect state birth control mandates or federal laws that already require insurers to cover pregnancy, childbirth, mental health, HIV treatments, and other services.

Before a vote on the Blunt-Nelson bill last week, the New York Times reported that “Republicans appeared to be divided.” In fact, just one Republican, liberal Olympia Snowe of Maine, voted against the measure. Three Democrats​—​Nelson of Nebraska, Bob Casey of Pennsylvania, and Joe Manchin of West Virginia​—​voted for it. The measure narrowly failed in the Democratic-controlled Senate.

The question now is whether supporters of religious freedom will keep up the fight. A number of freshmen Republican senators, like Kelly Ayotte of New Hampshire and Scott Brown of Massachusetts, have tackled the issue head-on. Polls taken before and after the fight over the issue show no erosion of support for Brown in the most liberal state in the country.

Yet other Republicans seem skittish about the issue because polls have supposedly shown support for President Obama’s “accommodation” of religious institutions. A Quinnipiac poll, for example, asked voters: “Do you think the federal government should require private employers to offer free birth control coverage as part of their health insurance benefit plans or not?” The results: 47 percent said the government should require free contraception, 48 percent said it should not. In other words, the federal mandate in general split the country down the middle.

The poll then purports to show that the Obama administration’s method of imposing a mandate on religious institutions is popular. Voters were asked:

As you may know, President Obama recently announced an adjustment to the administration’s health-care rule regarding religiously affiliated employers providing birth control coverage to female employees. Women will still be guaranteed coverage for birth control without any out-of-pocket cost, but will have to seek the coverage directly from their insurance companies if their employers object to birth control on religious grounds. Do you approve or disapprove of President Obama’s decision?

Worded this way, 54 percent approved, 38 percent disapproved. But the question didn’t poll the policy, it polled Obama’s spin. There was no mention that the federal government would require anyone to do anything. At the very least, a fair question would also present the other side of the argument​—​that Obama’s “adjustment” is an accounting gimmick to which religious institutions still object.

Rasmussen polls show that support for Obama’s policy depends on how you ask the question. Although voters are divided 43 percent to 39 percent on the general policy of requiring contraception coverage, voters oppose mandatory free coverage of the “morning-after pill” 50 percent to 38 percent. No polls have yet been taken on Obama-care’s mandatory free coverage of the “five-day-after pill” called “ella” that can induce abortions during early pregnancy, according to animal testing. And how would voters respond when asked if the federal government should fine religious institutions that refuse to comply with the mandate?

The debate may still be won or lost. The pro-mandate Democrats and their allies in the press have framed it as a fight about “denying access” to birth control. But recall that the “health care reform” bill itself was popular in polls in the spring and summer of 2009. Democrats and the press misled the public about how much it would cost, how many would lose their current insurance, how it would use tax dollars to help pay for abortion-on-demand. Yet opponents of Obama-care managed to get the word out and turn public opinion against the law​—​because it is a bad law and the facts are on their side.

The opponents of Obamacare’s newest mandate requiring free coverage of abortion pills and contraception again have the facts on their side. The mandate provides opponents with the opportunity to again make the case against Obamacare. As one popular sign from the 2009 and 2010 Tea Party rallies warned, paraphrasing P.J. O'Rourke, “If you think health care is expensive now, just wait until it’s free.” The price of “free” health care will be steep in terms of dollars, but even steeper in terms of freedom.

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