This election season, perhaps in an attempt to win the so-called women’s vote, the marketing efforts for Obamacare targeted my gender. “Thanks to the Affordable Care Act,” Representative Nancy Pelosi and Secretary of Health and Human Services Kathleen Sebelius cheered in one editorial, “a new day for women’s health has arrived.” They’re referring to the provision that all health plans must now include coverage for contraception and other women’s services — and must do so without charging co-pays or deductibles for them.
Given that I have two X chromosomes and am not Catholic, you might be surprised to learn that I’m not cheering along. After all, what woman of child-bearing age would be against free, FDA-approved birth control?
But the alternative is not really between free contraception and contraception I have to pay for. It’s between two visions of the American health care system: one in which I’m free to make decisions and one in which that freedom is eroded.
For other types of insurance, I have much more control over the coverage I judge best for my individual situation. If I lived in Oklahoma, I may want to choose a policy with robust windstorm coverage, since the region is more prone to tornados. Damage from earthquakes is rare in the state, so I may decide to forego buying coverage for that. But if I lived in the earthquake-prone state of California, as I do, I may choose to load up on earthquake-damage protection. If I lived along the Gulf Coast, on the other hand, I may decide it’s a good idea to purchase protection from hurricane damage.
I can hardly make the same kinds of decisions when it comes to my health insurance, which is much more heavily controlled by the government. For example, when the government mandates that all health plans include coverage for contraception (never mind without co-pays or deductibles), what that means is everyone, including every man and every woman who is past child-bearing age, is required to purchase coverage for that benefit. The purpose is to make us pay a portion of its cost for those women who use it.
Mandating that certain benefits be included in insurance policies is not a phenomenon new to Obamacare. Fueled by the view that it is permissible to force the medical expenses of some onto others, states have imposed benefit mandates in various forms for more than sixty years. Men are routinely forced to pay for services only women use. Non-addicts are forced to pay for the alcohol and drug rehabilitation of addicts. Bachelors are forced to pay for the marriage therapy of couples. Couples who can conceive on their own are forced to pay for the in vitro fertilization of those who can’t.
According to the Council for Affordable Health Insurance, each mandated benefit can raise the price of our insurance policies by up to 10 percent, and some states mandate more than sixty different benefits.
In a similar vein, Obamacare now requires that “essential health benefits” — benefits within ten federally determined categories — must be included in all policies sold on the individual and small-group markets. State governments and the thousands of lobbyists buzzing in their ears recently wrapped up the process of deeming what counts as “essential.” According to one pressure group, massage therapy, yoga and meditation instruction certainly do.
What this means is not only more expensive premiums but further entrenchment of a health care system in which my individual judgment is declared irrelevant.
As a young and relatively healthy person trying to save for a down payment on a house, I may decide to insure only against catastrophic events. As a female who one day wants children, however, I may want to add coverage against the risk of being unable to conceive.
But instead of leaving insurers free to offer such tailored policies and leaving me free to decide the coverage that best meets my individual needs, the government today dictates to us the coverage that may be bought and sold.
This is the opposite of the direction I want to see our health care system moving.
If an insurance company is willing to offer me coverage for contraception, and if such coverage makes financial sense to me, that’s great. But if the alternative is between being left free to make this choice and being coerced into a policy constructed by a government bureaucrat, I’d rather buy my own contraception, thank you very much. Walmart sells a $9 monthly supply.