WASHINGTON — When the Obama administration first unveiled its contraception mandate last August, Americans were told that medical experts had compiled the list of co-pay-free “preventive services for women” and that “cost-effectiveness” played no role in the decision-making process.
Last week, the administration appeared to contradict its earlier message when Health and Human Services Secretary Kathleen Sebelius testified before the House Energy and Commerce Subcommittee on Health and claimed that expanded access to contraception would bring costs “down, not up” for insurance carriers.
Additional justification for the controversial policy was offered at another House hearing, which featured Dr. Linda Rosenstock, chairwoman of the Institute of Medicine’s Committee on Preventive Services for Women, which included contraception in its list of recommended co-pay-free services.
Rosenstock told the committee that contraception services “enable women and couples to avoid an unwanted pregnancy and to space their pregnancies to promote optimal birth outcomes.”
So what’s going on? Do American women need “free” contraception because it’s good for their health, or because it saves Uncle Sam and health insurance providers money? Is it for devoted couples spacing children, college students seeking hassle-free sex, or female patients with medical problems — as Sandra Fluke recently asserted in testimony before House Democrats?
For many Catholics, Sebelius’ statements before the House Energy and Commerce Committee are the most troubling, because they echo past arguments used to justify coercive population-control policies in developing countries. Advocates of such polices have argued that suppressing human births will promote a nation’s economic well-being — an assertion that demographic experts like Nicholas Eberstadt have strongly challenged.
In her testimony, Sebelius sought to explain why insurance carriers would accept President Obama’s Feb. 10 “accommodation,” designed to address the objections of religious groups that refused to cover abortion-inducing drugs and other services that violated their moral teachings.
The president determined that insurance carriers would be required to cover the costs of contraception coverage for private employers that objected to these services on moral or religious grounds. But critics have dismissed the “accommodation” as an “accounting trick,” and they have predicted that insurance carriers will pass on the costs of coverage to religious employers through increased premiums.
Not Having Babies a ‘Benefit’
Pressed to respond to this critique, Sebelius suggested that insurance companies would welcome the new policy: “The reduction in the number of pregnancies compensates for the cost of contraception.”
Rep. Tim Murphy, R-Pa., asked her, “So you are saying: By not having babies born, we are going to save money on health care?”
Sebelius replied, “Providing contraception is a critical preventive-health benefit for women and for their children.”
Murphy responded: “Not having babies born is a critical benefit. This is absolutely amazing to me. I yield back.”
Sebelius repeated: “Family planning is a critical health benefit in this country, according to the Institute of Medicine.”
Back in 2009, then-Speaker of the House Nancy Pelosi offered her version of the anti-poverty argument for contraception in a statement suggesting that government-funded birth control would actually boost the U.S. economy.
A similar assertion was made in an Aug. 1, 2011, CNN story marking the introduction of the HHS contraception mandate: “Supporters also say covering contraception helps the government save money up front. According to an analysis from the Guttmacher Institute, in 2006, of the 2 million publicly funded births, 51% resulted from unintended pregnancies, accounting for more than $11 billion in costs.”
But the contraception mandate requires private employers to provide contraception coverage, while CNN, like most Democratic supporters of the HHS mandate, cites data on the costs of “publicly funded births.”
There is on-going debate and conflicting research about whether access to contraception actually reduces unintended pregnancies or abortion rates. (Recent data confirm that out-of-wedlock births among U.S. women under 30 are now the norm, though it is not clear whether these births were “unintended” or merely growing evidence that sexual relationships, marriage and procreation have been compartmentalized—in part, say Catholic moral theologians, because of a “contraceptive mentality.”) But, clearly, private health benefits will have no direct impact on at-risk teenagers and struggling single mothers in the inner city. So why make that argument?
One reason, perhaps, is that scary statistics make U.S. tax-payers nervous and lead some to conclude that these “unwanted” children will end up on the public dole. Better, perhaps, to prevent those “unintended” pregnancies in the first place. Indeed, a few years back, one social researcher actually made the argument that legal abortion had helped to reduce the nation’s crime rate.
15-Year-Old Recommendation
A different explanation for the HHS mandate was offered by Dr.Rosenstock, the UCLA public health expert who chaired the committee that decided which preventive services for women would be mandated under the new Patient Protection and Affordable Care Act.
Last week, in her testimony before the House Judiciary Committee, Rosenstock did not offer a cost-benefit analysis of “contraception services.” She sought to characterize the deliberations of her “independent” committee as scrupulously scientific and set apart from political or economic calculations.
Rosenstock reminded the committee that the Institute of Medicine “is the health arm of the National Academy of Sciences, an independent, nonprofit organization that provides unbiased and authoritative advice to decision makers and the public.”
“Women with unintended pregnancies are more likely to receive delayed or no prenatal care and to smoke, consume alcohol, be depressed and experience domestic violence during pregnancy,” she noted. “Unintended pregnancy also increases the risk of babies being born preterm or at a low birth weight, both of which increase their chances of health and developmental problems,” she told the House committee.
Her testimony did not distinguish between the needs of poor, at-risk female patients and other women holding jobs in private companies and nonprofits. Nor did Rosenstock acknowledge that representatives of Catholic health-care institutions — the second-largest group of health-care providers in the nation — were not invited to testify at the public forums organized by her committee.
Catholic health care was snubbed, at least in part, because church-affiliated institutions reject both the anti-poverty argument for contraception, and the related notion that “pregnancy is a disease” — to repeat the USCCB characterizatation of the HHS mandate. Commentator Ross Douthat, in a Feb. 18 column in The New York Times, offered a secularized version of one argument against the mainstream public health community’s stance on contraception: “t’s more important to promote chastity, monogamy and fidelity than to worry about whether there’s a prophylactic in every bedroom drawer or bathroom cabinet.”
In fact, the record suggests that Sebelius left little to chance when she asked the Institute of Medicine to compose a list of mandated services. A Feb. 2, 2011, story in The New York Times notes that the IOM issued a report more than 15 years ago that called for “increasing the proportion of all health-insurance policies that cover contraceptive services and supplies, including both male and female sterilization, with no co-payments or other cost-sharing requirements.’”
The Times’ Take
In January 2011, five months before the IOM would release its report, the Times story outlined the administration’s game plan: The “Obama administration is examining whether the new health-care law can be used to require insurance plans to offer contraceptives and other family-planning services to women free of charge.”
The Times reported that the administration “expected the list to include contraception and family planning because a large body of scientific evidence showed the effectiveness of those services. But the officials said they preferred to have the panel of independent experts make the initial recommendations so the public would see them as based on science, not politics.”
But the Times story also concluded with the anti-poverty argument for contraception. Isabel Sawhill, an economist at the Brookings Institution told the reporter: “We have rigorous evidence that every dollar invested in family planning saves more than a dollar in welfare and social service costs for children that result from unintended births.”
Not a Fluke
So far, the American public appears to have accepted the argument that contraception coverage effectively addresses low-birth-weight problems and bulging welfare rolls. Even critics of the mandate have generally ignored the administration’s attempt to conflate the anti-poverty argument for contraception with the very different social and economic profile of women gainfully employed by private companies and nonprofits.
Yet the cost-benefit explanation doesn’t make an especially persuasive case for imposing the contraception mandate on religious employers. And perhaps that’s why House Democrats like Pelosi readily provided a public forum for the Georgetown Law School student Sandra Fluke.
“I attend a Jesuit law school that does not provide contraceptive coverage in its student health plan,” Fluke stated in testimony that also attacked two bills designed to protect the conscience rights of institutions and individuals that oppose the contraception mandate on moral or religious grounds. “And just as we students have faced financial, emotional and medical burdens as a result, employees at religiously affiliated hospitals and institutions and universities across the country have suffered similar burdens.”
Fluke’s most compelling stories dealt with unidentified female students who were technically able to receive needed medical assistance but didn’t for reasons that are not entirely clear. Yet, these stories were repeated in media coverage of her testimony and the related furor prompted by Rush Limbaugh’s attacks on the Georgetown law student.
The full impact of Fluke’s contribution to the public debate has yet to be determined. At the very least, Fluke offers another voice and another argument, joining Sebelius, Pelosi and a host of experts in making the case for an iron-clad federal contraception mandate.
Register senior editor Joan Frawley Desmond writes from Chevy Chase, Maryland.
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Many state funded health departments already offer birth control for free or reduced prices as does Planned Parenthood. These services are offered regardless of religious belief. Many college students do not have health insurance or have limited health coverage through their school. Most college students have a very low income and as such are eligible for services at state health departments. A little over two miles from Georgetown University is a Planned Parenthood clinic. I fail to see how Georgetown University students do not have access to birth control or other options. True it is not provided by Georgetown University, but that doesn’t mean that it is impossible to get. Forcing religious institutions to provide such things that is against their beliefs is WRONG. Especially if access isn’t limited only to whether or not that group provides it.
Dear Ms. Desmond,
I would think that since you have written this article for a religious institution, you would feel obliged to follow the highest ethical standards and not use false or misleading arguments. But sadly you have written a piece that is both misleading and mistaken.
You ask which of the arguments given to support the provision of contraceptive health services:
preventive services for women improves health, access to contraception would bring costs “down, not up” for insurance carriers, it would enable women and couples to avoid an unwanted pregnancy and to space their pregnancies to promote optimal birth outcomes and such service are critical to female patients with medical problems. It is quite clear that they are all true. You do not bother to try to deny the truth of any of those statements - apparently realizing they are all true. Instead, you falsely try to portray these reasons as something that must be either/or.
And your argument that the a reason for providing them is “hassle free sex” is Rush Limbaugh’s argument, not the administration’s. It is not worthy of such a magazine to stoop to such lows.
The phrase “pregnancy is a disease” is not how it is viewed by Democrats, liberals, the vast majority of women - or members of the Obama administration. It does seem to be one of your talking points however. Again, not worthy of you.
Your statement that: “Sebelius’ statements before the House Energy and Commerce Committee are the most troubling, because they echo past arguments used to justify coercive population-control policies in developing countries” is beyond the pale. To suggest that providing health care for people to use as they see fit - is akin to coercive and oppressive third world regimes, is beneath contempt.
You statement that there is “considerable debate and conflicting research about whether access to contraception actually reduces unintended pregnancies” is false. The evidence and the scientific consensus on that issue is clear and comprehensive and convincing. Access to effective birth control dramatically decreases unintended pregnancies and all the human sorrow that can be associated with it.
You further confuse the issue of who is paying for this. If it is through someone employment - you are not “giving it” to them. They earned it. They created all the wealth that pays for it through their labor. And the choice of what they do with their health care benefits should be decided by the employee with the help of their doctor - not by fiat from you or your colleagues.
Please take greater care in the future to follow all 10 commandments - and refrain from bearing false witness against your neighbor.
Yours Truly,
Barry Nolan
Sounds like the time when Moses was up the mountain to communicate with God for 40 days and returned to the Isreals gone mad and rejecting God by worshipping a Golden Idol. What has happened to morals in this country of ours?
the father of lies is working overtime. Pray, fast, give alms. Jesus, I trust in You! JMJ+
Hey Barry Nolan—- So many errors so little time and space - however there is time and space to deconstruct the biggest and most egregious error in your homily:
Your statement that “access to contraception would bring costs “down, not up” for insurance carriers” is patently false. It is worse than false it part of a well thought out and devious strategy that speaks volumes about just how disingenuous Mzzz Sibelius and her minions are.
Roughly 6 trimesters ago back in 2010, that hard working first class journalist Judie Brown correctly pointed out what was being cooked up by Obama, Sibelius, Pelosi etc :
http://cnsnews.com/blog/judie-brown/cheaper-free-birth-control-spells-c-o-e-r-c-i-o-n
wherein Judie pointed out:
“Despite all its empty, deceptive rhetoric about expanding health coverage to the poor, Planned Parenthood, in all its diabolic wisdom, realizes something most Americans don’t: If it succeeds in getting birth control on the list of preventive services in the health care reform law, not only will new health insurance plans be required to fully cover the cost, but state Medicaid programs will be required de facto to cover the full cost of even the most expensive, invasive forms of birth control, such as implants and IUDs, to millions of women with incomes well above poverty level, providing an instant pot of gold for the abortion and birth control mogul.”
So there you have it Barry ... got to hand it to you ... your side played Political “Chess” our side played Political “Checkers”. You got your “birth control” on the list of preventive services in “Obamacare” ... and of course if “Obamacare” is not overturned Sebelius WILL rob more money from Medicare & Medicaid to fund the most $$$-EXPENSIVE-$$$, invasive forms of birth control, such as implants and IUDs, for millions of women.
So stop trying to sell us stupid - we are “full up” out here in America - even in the short term this will COST $$$$$ ... and in the long term it’s COST’S ARE “INFINITE” AS IT WILL COST SOULS.
Dear Mr. Nolan,
Only of there were no humans would there be no human sorrow. It is better to live with sorrow than to not live at all.
Sincerely,
Ed Lane
So the argument is that woman can just go the Planned Parenthood, an organization that the GOP is systematically dismantling, or use a state poverty agency’s resources. So the cost burden would be passed to PP or the taxpayers. That will never stand up in a civil court.
For all who are impoverished by the overwhelming expense of preventing the “human sorrow” of pregnancies I found the following on ebay; “Trojan Pleasure Pack 36 count Value Pack!” for $17.95. I am confused though if it is to be used for pleasure or for liberating the male dominated woman.
http://compare.ebay.com/like/230752305236?var=lv<yp=AllFixedPriceItemTypes&var=sbar
These good people claim their intention is to raise the status of women and children. Yet the obvious result is the elimination of children and the one thing that only women can do. And do quite well, in fact!
Today a mandate for free birth control, tomorrow a mandate for who must take the birth control. Who are today’s “undesirables”, who are tomorrow’s?
So, what they are saying it that birth control should be free so that “those” children won’t be born and “we” can have our recreational sex without the stigma of our abortions or our “unwanted” illegitimates.
Fluke is a disgusting woman. She should be expelled from Goergia State. She has no moral values. Not only does she feel contraceptives should be paid under Obama care, she feels sex changes should be, too Rush was wrong for calling her a “slut”—For she is a “!@#$%”—for she wants poeple to PAY for her to have casual sex. If it walks like a duck and looks like a duck….It’s not name calling, it’s calling her what she is—Truth hurts. No one in the media says a word about the crass and inappropriate back lashing BILL MAHER has said about Sarah Palin and Tim Tebow.
It’s even a shame that our current president praises this woman. Just goes to show you how down with the devil he is, also.
I urge ALL practicing catholics to vote Obama OUT! He and his followers are destroying America
There is nothing liberating about Fluke or Obamacare.
Posted by dch on Wednesday, Mar 7, 2012 6:28 AM (EST):So the argument is that woman can just go the Planned Parenthood, an organization that the GOP is systematically dismantling, or use a state poverty agency’s resources. So the cost burden would be passed to PP or the taxpayers. That will never stand up in a civil court.
—Your posting has no clout, considering much tax money funds planned parenthood.
Next year Sibelius will make the very same arguments in support of mandated abortion coverage. And why not, abortifacients are already included as a free critical health benefit not only for abused and depressed alcoholic smokers, as la Sibelius has it, but for well heeled Gtown law students.
I wanted to addrss the issue of scientific evidence regarding birth control. The Pill has been widely available for 40 years. During that time have unintended and single parent births increased or decreased? What about abortions? During that time have sexually tarnsmitted diseases increased or decreased? What are the societal benefits of widely available birth control? This reminds me of the discussion around sex education which was supposed to result in lower teen pregnancies and stds. The opposite happened. If I may paraphrase, are you going to believe the experts or your own lying eyes?
When will Sebelius be publicly excommunicated? The lack of courage exhibited by her politically focused and cowardly bishop and priest is a scandal to the weak and encourages cafeteria Catholics to mock our Lord… history is replete with the ghosts of haughty empires that mocked the Holy One.
Posted by Jim B on Wednesday, Mar 7, 2012 11:07 AM (EST):I wanted to addrss the issue of scientific evidence regarding birth control. The Pill has been widely available for 40 years. During that time have unintended and single parent births increased or decreased? What about abortions? During that time have sexually tarnsmitted diseases increased or decreased? What are the societal benefits of widely available birth control? This reminds me of the discussion around sex education which was supposed to result in lower teen pregnancies and stds. The opposite happened. If I may paraphrase, are you going to believe the experts or your own lying eyes?
—-All of these instances have lead to more abortions (failed contraception), stds and aids (more random sex), more single mothers/dead beat dads=breakdown of the family, increased poverty, and, I feel, more gays because of lack of male role models, children experimenting with sex at earlier ages and now, in grade school, children have been sexually assulting other students. Plus not exposing kids to prayer or the 10 commandments in schools lead kids not to be influenced by morals or values within the walls of education.
These past 50 years in the USA have been nothing but a jubilee of filth.
The ex-Gov. of Kansas was not put in her place by the Church years ago. Georgetown & the other supposedly Catholic Colleges also have done as they please without the proper Church leadership. Heretic CINO politicians thumb their noses at every dogma & the Bishops do nothing. The Pro-Abortionist in the oval office referenced who started the downfall of the Church & USCCB in America back in the 60’s, “bernardin” & his seamless-garment pro-homosexual agenda. All of the present day turmoil can be traced directly back to our Bishops. Pray that a strong one will step forward & correct all of the past errors !
Mrs. Desmond, thank you for a great, but long article. Too bad that those such as Barry Nolan and dch are so clueless. Sex is NOT A GAME and women’s (or men’s) bodies are toys. Hell is full of those that think and act in this manner. As we all know, “planned parenthood” don’t donate their “services”, but in fact, charge up front, cash please, (no need to keep records) and their condoms have more than a 50% rate of failure to help increase the money flow from abortions, STD tests and so forth. +JMJ+
The argument that Sibelius, Pelosi, et. al, are making, about family planning, and conflating free contraception for impoverished women and free conception for employed and/or independent women who are married, sounds suspiciously like the argument that the lesser fit or the unfit should be allowed to avoid reproducing. The gist of the argument of these women is the Eugenics argument, made by Sanger, et.al. in the early 20th Century. This is the New Eugenics—government funded, sponsored, or coerced funding of contraception to prevent reproduction, to prevent the State from being burdened by the unwanted and the unfit. This is Oliver Wendell Holmes, Jr, in Buck v. Bell, writing, “Three generations of imbeciles are enough! Sterilize her!” (The person of whom he spoke was not, and he should have known that she was not, an imbecile—but he didn’t care about the ‘fine points’ of the situation—she was an unfortunate soul that simply because of circumstances completely beyond her control, Holmes deemed her “unfit”). It is the full throated argument that abortions are the main component of reducing crime rates. It is the constrained view that defines humans as a nuisance species that is despoiling the planet and must be culled and managed like the elk herds in the Yellowstone (see the book, Playing God in Yellowstone, for the bloody description of that endeavor). This is the Progressive view of the human. Not a little lower than the angels, but significantly lower than the innocent beasts that roam the planet, a scourge, a blight, a pestilence on the land, that the self-anointed elites must control. This is the Pragmatist view of Rorty, Rawls, yes, even of John Dewey and his fellow Eugenicists of the early 20th Century, who were such devotees of the Stalinist Soviet Union. Death is not a problem for these abortion libertines. Life is the problem. Indeed, Fluke, who obviously aspires to be included in the self-anointed elite, is willing to consider herself one of those who should limit her reproduction because she is not yet among the “fit”, the “worthy”, to be included among the ruling elite. But, by debasing herself before them sufficienlty, allowing herself to be exploited for their purposes by the self-anointed elite, she may be included among them. Her path to self-validation, her identity, is through the State, the ruling elite, and her obeissance to them, and, in turn, her exploitation of her fellow citizens. She fits the definition of an apparatchik Obama has treated her as a “hero” of the people. This is not only the New Eugenics. This is the New Orwell speak. The location changes. The propaganda approach remains the same. The State is her father and her mother, her Savior and her God. The State gives her her meaning.
Margaret Sanger must be smiling from hell. Population control has been one of the pilars of the progressive movement since it’s inception as they establish their utopia. We saw and see the result in Nazi Germany and the one child policy in Communist China today.
A major problem with the approach of “curing” poverty induced by unintended pregnancy through contraception taken by Obama and liberals in general is that it seeks to treat these problems by addressing the symptoms by means that actually encourage the cause. At bottom, the cause is one of the will: Unrestrained, untempered indulgence of the passions. Rather than seeking means that address this underlying cause and encouraging people to become master of their passions, the means chosen (contraception), actually encourage people to indulge their passions, thus losing even more control over them. In the end, they become enslaved to their passions, which, I strongly suspect, is the end game anyway. A person ruled by his passions and emotions is easier to manipulate.
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