Does health care reform’s promise of preventive care extend to free birth control? Officials at the Department of Health and Human Services have 18 months to decide whether to require insurers to provide oral contraceptives, IUDs, and other prescription birth control with no co-pay. With pro-choice Secretary Kathleen Sebelius at the helm, HHS is expected to say yes. [Update: The Wall Street Journal is reporting that birth control will not be on the White House's preliminary list of free preventive services, to be issued today. However, as Miriam Perez of feministing explains, HHS will ultimately have the final word. Observers, including Dana Goldstein who covers reproductive rights for the Daily Beast, are optimistic that the pro-choice side will carry the day at HHS.]
At this point in the process, social conservatives are shut out in the cold, quaking with impotent rage. Now that the reform bill is law, HHS has to interpret the rules—and the Obama administration officials at HHS can’t be swayed as easily as elected officials.
Religious right on the warpath
Predictably, the U.S. Conference of Catholic Bishops (USCCB), the National Abstinence Education Association, and the Heritage Foundation are up in arms. They’ve picked a deeply unpopular battle. Abortion remains controversial in some circles, but birth control is as American as baseball. The vast majority of sexually active women in the U.S. tell pollsters that they are not trying to become pregnant, and 89% of them are using some form of birth control.
“Seriously,” writes Monica Potts of TAPPED, “a battle over contraceptives?” Over 15 million Americans currently use hormonal contraception. Studies show that the vast majority of Americans are morally comfortable with birth control.
Expanding access to birth control is smart policy because it reduces health care costs, as Suzi Khimm notes in Mother Jones. Birth control is a lot cheaper for insurers than pregnancy and childbirth. Free birth control could change women’s lives for the better. In this economy, $30-$50 a month for hormonal birth control can be a major obstacle for many. As Michelle Chen notes in ColorLines, women of color are among those hardest hit by out-of-pocket costs.
Birth control as common ground?
Many centrists hope that contraception will be a source of “common ground” between the pro-choice and anti-abortion camps. The premise sounds reasonable. If anti-choicers oppose abortion, surely they will support measures proven to reduce the abortion rate, like expanded access to contraception. Political scientist Scott Lemieux argues in TAPPED that conservative opposition to birth control coverage is further proof that the common ground hypothesis is wishful thinking:
The problem with this line of reasoning is that it ignores the broader set of assumptions about women and sexuality on which actual opposition to abortion is based. Consider anti-choice Republicans, who consistently opposed expanding contraceptive use: Given the choice between reducing abortion rates and controlling female sexuality, they will always choose the latter. Thus the idea that contraception can be a means of achieving a ceasefire in the culture wars has always been a fantasy. Liberals and conservatives aren’t just divided by abortion but by broader questions of female equality and sexual freedom.
The USCCB clearly understands that birth control is broadly popular. Its lobbyists aren’t even trying to argue that birth control shouldn’t be covered because it’s sinful. Instead, they are playing semantic games about what constitutes preventative health care. According to the USCCB, birth control shouldn’t count because fertility isn’t a disease. Be that as it may, pregnancy is a life-altering health condition that can kill you. As a matter of fact, the Catholic Church is on the record as saying that pregnant women must sacrifice their own lives for their fetuses. Ergo, pregnancy prevention is preventive health care.
Approving free birth control would go a long way towards restoring the trust between the Obama administration and its pro-choice base, at low political cost. It seems unlikely that the USCCB and its allies have the power to fuel a national backlash on this one. After all, three quarters of U.S. Catholics disagree with their own church’s teachings on birth control.
Speaking of the Department of Health and Human Services, Megan Carpentier at RH Reality Check wonders what happened to President Barack Obama’s early promise to repeal the so-called “conscience clause” rule that allows health care workers to opt out of providing reproductive health care that conflicts with their anti-choice principles. The rule is still on the books, over a year after Obama pledged to repeal it.
Finally, how did some BP oil spill cleanup workers end up living in formaldehyde-laced FEMA trailers ruled unfit for human habitation? As I report for Working In These Times, Rep. Henry Waxman (D-CA) chair of the House Energy and Commerce Committee, wants answers from FEMA and the General Services Administration about how these trailers found their way back onto the market.
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