October 10, 2017
Birth control. Currently nearly two thirds of all women between the ages of 15 and 44 are on it. Nearly every woman in the U.S. at some point will use it. Meanwhile, thanks to a new rule from the Health and Human Services Department, as of this moment the person in charge of your insurance can refuse to offer no co-pay coverage in your plan.
But what if maybe that’s not such a bad thing after all?
No, really, hear me out.
Obviously, there is no question that effective, reliable contraception is the greatest medical breakthrough in modern history for those who are able to get pregnant. The introduction of the birth-control pill, diaphragms, IUDs, and whatever is your favorite sperm-stopper is without a doubt the reason that so many can now get college degrees, enter the work force, raise families later in life or not at all, and limit exactly how many children we choose to have. It has allowed us to get better jobs, space out our pregnancies, live healthier lives and stop dying so damn much in childbirth or clandestine attempts at abortion.
It has also allowed couples a freedom that had been blocked off from them for much of history: the ability to wait until the right partner comes along before starting a family, to wait until they were financially and emotionally ready, and to not stretch themselves so thin by raising more children than they could handle.
To almost everyone in our country, these are all uncontroversially accepted as good things. But of course then there are the others, that very small fraction of people who believe that contraception divorces marriage from childbearing, eroding the meaning of committed relationships. The people who fear that if a man and a woman can be in a sexual relationship with no possibility for offspring from their union, well, that undermines their whole argument against allowing marriage between same-sex couples, too. Those who think that a woman who doesn’t bear a child is deprived of her natural purpose, and that denying the means to stop pregnancy is necessary to urge her toward her biological goal.
This group is thankfully small, even in religious circles. For every religious group praising Trump’s new rule ending the no-co-pay birth control mandate for those with religious or moral objections, there are more in each denomination condemning the change, stating that the decision to prevent a pregnancy should lie in the hands of the person who can get pregnant, not her employer, school, or other entity in charge of insurance plan decisions.
Now, this new rule is just the start of the unraveling of the birth-control mandate, if not the entire Affordable Care Act itself. Unable to accomplish repealing Obamacare through legislative efforts, the Trump administration is coming for it piecemeal instead, through executive actions and departmental rule rewrites. This way conservatives can eliminate each plank of health-care reform without need for actual public support, all while Congress keeps their own hands clean as they head into reelection.
With the new expanded religious exemption for businesses and non-profits, anyone can now take the opportunity to block no-co-pay birth control from their insurance plans. That is an immediate crisis for those who are insured by the 200 entities that had been suing the government, arguing their “religious liberty” was being trampled by the mandate, which could be as many as 120,000 insurees. It’s also a looming disaster for the hundreds of thousands more could be affected as colleges, hospitals and other religious institutions (or just businesses with far right social conservative owners) also pull the benefit.
However, it’s also a moment that is galvanizing states across the nation that finally realize that the religious right has taken over the country and is turning it into a place where their “religious” freedom trumps every other civil right. California already filed suit against the administration, stating that the new rule “specifically targets and harms women—thus denying their rights to equal protection under the law—and allows employers to use their religious beliefs to discriminate against employees.” Minnesota and Pennsylvania are calling on legislators to enact bills to protect birth control in all insurance plans offered in the state.
And Massachusetts is moving forward on a bill that will allow most oral contraception and emergency contraception to be obtained for free, and up to a year’s worth at once. The change would remove any barrier that the HHS’s new rule might place in the path of employees who work for religious companies.
It’s Massachusetts’s response that makes the most sense, and where we can see the Trump birth-control mandate rollback as an opportunity, rather than a loss. After all, birth control—and health insurance itself—never should have been in the hands of any employers in the first place. It doesn’t make any difference whether your boss chooses not to offer birth control because they believe contraception is a sin or chooses to reject addiction or mental-health services because they believe those illnesses are character weaknesses instead of genetic predispositions, health services should never be determined by employers.
Whether or not the Trump administration’s new birth-control exception withstands legal challenge, we can no longer ignore the fact that for all of the benefits that Obamacare brought those who were uninsured or underinsured, it has failed in one very important way. In far too many cases insurance coverage and its benefits are still set to the whim of employers, and as we can see through acts like red-state refusals to expand Medicaid or allow exchange plans with abortion coverage, insurance’s offerings are far too reliant on the political leanings of those in power.
The rollback of the birth-control mandate is the clearest sign yet that we need employers out of insurance decisions. While opening up the Medicaid exchanges for all people regardless of income would be a good start, it still isn’t enough. We must have a single-payer system that would get coverage completely out of the hands of all employers once and for all.
Maybe the current administration’s determination to destroy Obamacare will inadvertently get us to a place where we can launch a single-payer system. You know, once we have a Democrat in the White House in 2020.