July 25 2011
Women Shouldn't Applaud One-Size-Fits-All Government Mandates About Contraception Coverage
Carrie L. Lukas
Rep. Lois Capps and Marcia Greenberger, president of the National Women's Law Center, are celebrating that the Institute of Medicare has offered new recommendations that contraception, as well as yearly check ups, support for breast feeding, counseling about STDs, and screening for domestic violence should all be considered "preventative health services" and be covered by health insurance companies without any co-pay. Since Obamacare will require all insurance companies to follow HHS recommendations about what constitutes "minimum essential coverage," these new guidelines are likely to become the law of the land.
Is this really good news for women?
In considering this issue, most people get hung up on the moral question that lurks within these determinations. Many, even most, women may consider contraception preventative medicine, but some find contraception morally objectionable. Should someone who considers the pill-let alone RU-486-the equivalent of abortion or even murder have to pay for these services?
That can be an interesting debate, but it's really beside the point when we are talking about government health care policy. The more important question is why government should impose a one-size-fits-all solution to question about which people can have deeply held differing opinions. Why couldn't someone who wants access to STD counseling and contraception choose insurance packages with those options, while those who object to the use of contraception go with insurance that just provides more basic services?
Part of this is likely cost-shifting: While advocates for expansive health care highlight cost-savings from preventative care, it seems clear that providing free preventative services entail additional costs, which is why insurance premiums go up when such mandates are put enforce.
Americans should be concerned about the direction we are heading in, with government boards deciding what everyone "must" have in terms of insurance coverage. Liberal women's groups will applaud government forcing insurance companies to offer additional coverage for women's services. Every other group will have their own list of what they believe is "essential" coverage, which is why in places like Massachusetts, we've seen the list of "necessities" grow to include IVF treatments and drug and alcohol counseling programs.
The simple fact is that we all have different definitions of what "essential" entails. And it shouldn't matter to you if my definition differs from yours so long as we are both allowed to exercise our free will and choose plans that make sense for us. But when government starts making sweeping decisions, it becomes a big problem: It becomes expensive, and not just in terms of lost dollars, but in the lost liberty to make choices that reflect our values.