Obama Overreaches on HHS Mandate
BY DANIEL KUEBLER
March 11-24, 2012 Issue | Posted 3/5/12 at 11:42 AM
It’s an understatement to say that the Obama administration’s announcement that it will require all health-care plans to include free coverage for contraceptives, abortion-inducing drugs (abortifacients) and sterilizations did not go over as smoothly as planned.
While the new rule is similar to provisions already in place in 28 states, the administration distinguished itself by failing to include an adequate religious exemption.
As a result, Catholic charities, colleges and hospitals will be required to provide services that violate their religious beliefs.
The lack of a real religious exemption triggered a wave of backlash that appeared to catch the administration by surprise.
Opposition from many religious circles was to be expected, but the fact that publications such as USA Today and The Washington Post came out in opposition to the lack of a religious exemption could not have been anticipated.
Caught in a firestorm of controversy, the Obama administration tried to wordsmith its way out of the mess.
Rather than admit they overstepped their constitutional authority by subjecting religious institutions to this rule, the president and his people merely switched the wording to state that the insurance companies were paying for the contraceptives rather than the religious institutions.
This is despite the fact that religious institutions are still the ones actually paying for the policy. The fact that they settled upon a semantic rather than a substantive change guarantees that the issue will not go away quietly, as the Obama administration had wished.
However, as the battle over a religious exemption moves forward, it is surprising that there has been little opposition to the mandate in general or to the fact that the new health-care law gives the administration the authority to make these unilateral changes to the insurance industry.
One gets the feeling that if religious colleges, charities and hospitals had been exempted from the start, no one would have blinked an eye over the federal government stepping in and mandating that all other insurance plans pay for contraceptives, abortifacients and sterilizations.
Why has there not been more outrage at the fact that Obamacare has given the federal government the authority to step into the market and dictate unilaterally what insurance plans we can purchase?
Why is there not more concern that the federal government is forcing contraceptive coverage on the entire populous?
The sad truth is that people have, by and large, fallen for the access-to-contraceptive argument and are content to let the government insert itself in this area.
Supporters of the new rule have taken advantage of this fact to mask what is really going on.
Like many other Obama surrogates, Sens. Barbara Boxer, D-Calif., and Patty Murray, D-Wash., have been out defending the ruling as an essential tool to ensure that women have access to “the full range of preventative-care measures.” Yet the rule has nothing to do with access to contraception.
No one in this country is being denied access to contraceptives, and the statistics bear this out.
In a country in which more than 90% of health plans already include contraceptive coverage, Planned Parenthood makes contraception readily available and the federal government aggressively promotes the distribution of free contraceptives to poor women, access to contraception is clearly not a problem.
In fact, a recent Centers for Disease Control study found that at least 93% of sexually active women of reproductive age have used some form of contraception, with 82% having used the pill.
These numbers should not be surprising, given that children are more likely to come home from school today with free contraceptives than they do with homework.
The numbers also reveal how disingenuous the access-to-contraception argument really is.
Only the grossly ill-informed or the hopelessly biased would spin this as an access-to-contraceptives issue. No one is preventing women from obtaining these services if they so choose.
In fact, from women’s health-care clinics to college vending machines, every woman knows where to find it. It’s as ubiquitous as aspirin, and it’s relatively inexpensive, too.
For those who actually have to pay for it, a month’s supply of birth-control pills costs less than cable or a cut-rate cell-phone plan.
The question is not about access or even affordability. The question is about who should be forced to pay for it. Will the government force employers and/or insurance companies to foot the entire bill, even those who have moral or religious objections? Or will they allow employers the freedom to decide what plans to offer their employees?
Given that more than 90% of plans already include this coverage, coupled with the fact that the federal government has aggressively been promoting the distribution of contraceptives to low-income women for decades, what is to gain from forcing the few plans that, largely for religious reasons, do not include these services to get in line?
Some have argued that the new rule is merely a deliberate assault on conservative religious groups, and given the level of rhetoric aimed at those who oppose the new rule, there appears to be more than a grain of truth in that sentiment.
Officially though, the administration has been touting the rule as a significant cost-saving measure. In fact, the inclusion of contraception and sterilization as required free preventive-care services stems from an Institute of Medicine report claiming the direct cost of unintended pregnancy in the United States is nearly $5 billion a year.
The IOM report suggests that providing free contraceptives would reduce unintended pregnancies and therefore drive that cost figure down.
Never mind that the same IOM report cited the CDC study that found 93% of sexually active women have already used some form of contraception. Never mind that the unintended pregnancy rate has remained stagnant for decades, despite an intense, coordinated campaign to put contraception into every nook and cranny of our lives.
The problem with unintended pregnancies in this country is not related to a lack of access to contraceptives.
Despite the fact that most women are using them, non-marital births, most of which are unplanned, are at an all-time high and have been trending upwards since the 1960s, when the contraceptive-distribution revolution began.
As a cost-saving measure against unplanned and unwed pregnancies, multiple studies have shown that increasing the availability of contraceptives has not been effective. It doesn’t even reduce abortions.
In fact, states that already mandate contraceptive coverage, with very narrow religious exemptions, such as California and New York, have some of the highest abortion rates in the country. In addition, over 50% of women who have abortions were using artificial contraceptive during the month they became pregnant.
But data be damned, because at the high altar of progressive orthodoxy, contraception is king. It must work, and it has to work, even if it has to be jammed down our collective throat.
But just to cover their bases, the administration included sterilization as a required free preventive service. While not perfect, it is much more effective at driving down the pesky cost of prenatal care and childbirth than contraception.
Yet there is no reason to suspect that the administration plans to end there. Given the lack of congressional oversight inherent in the new health-care law, there is nothing preventing the Obama administration from unilaterally adding abortion as a required free preventive service.
It’s a huge cost-saver because, like sterilization, it removes the costs associated with childbirth and child rearing. What about mandating euthanasia coverage? The potential cost savings there are enormous.
While the lack of a religious exemption is what caught the public’s attention, the issue goes much, much deeper than that.
Obamacare gives the federal government a blank check to impose its will upon health-care delivery in this country.
It gives it the power to control the insurance industry through mandates in coverage, to control the medical-device industry through mandated taxes, and, most importantly, to control the lives of every citizen through mandated and rationed care.
The legislation is so vague that nobody, not even the administration, knows the limits of its reach. When the Congressional Research Service scored the bill for how many new, unaccountable regulatory or oversight boards it would create, the answer came back that it was virtually unknowable.
The reason for this is that the bill gives the administration unprecedented powers to create new boards and write new rules and regulations as it sees fit.
If it wants to require abortion coverage, there is a board for that. If it wants to impose euthanasia, there is an oversight committee for that. If it wants to write a rule requiring that Catholic charities, hospitals and universities pay for contraceptive coverage, there is a process for that.
And the administration has shown no qualms about using these processes to promote the contraceptive agenda, even if it means trampling upon the religious freedoms guaranteed in the Constitution.
Daniel Kuebler, Ph.D.
Professor of biology
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