A Health Care Flap

The President has stepped into a mess on this one, and there is some conflict between religious freedom and human rights here. But there is also too much misinformation going on, particularly in these two areas:

1. A majority of states already have some form of prescription equality legislation that applies to the public operations of churches (like schools and hospitals that employ or serve non-members). In addition, since the early days of the Bush administration, there have been federal equal access rules, and indeed several Republican senators, like Susan Collins and Olympia Snowe were co-sponsors on legislation to require prescription equity across sexes (e.g., if you cover Viagra, you cannot deny women equal access to birth control).

Many large Catholic universities currently cover birth control for staff in their plans, and if they don't they are already likely in violation of existing rules. In short, since the churches have not shut down operations or terminate coverage in these situations, they are not likely to do so now, except to cut off their nose to spite their face.

2. The new rules do require zero co-pay rules to apply to many preventative medical treatments, and birth control is one of them. This gives equal access to poor people and saves $20,000 to $100,000 or more per prevented pregnancy, and likely prevents many abortions (isn't this the goal?).

The argument that, if no co-pay is required, the institution is subsidizing birth control reveals nothing more than an ignorance of how private health care is currently being funded, and will continue to be funded under the Affordable Care Act.

Institutions even as small as community colleges and small universities usually save a lot of money on health care costs by putting all university and employee contributions into a shared pool, from which claims are disbursed. The insurance company's role is as an administrator and negotiator with the health care providers. There is an insurance policy written, but ONLY for the event that the shared pool is depleted in a given year. Good insurance companies, however, know how to set the contribution level so that this rarely happens.

Since almost no employer contributes the full cost of health care anymore, the shared pool is this mix of what individual employees put in and what the institution puts in. The co-pay does not cover the full cost of the birth control, but it usually DOES fall beneath the level of the employee's contribution. All the rules say is that a woman's access to birth control (over 98% of childbearing-age Catholic women) is as important a health decision as the zero co-pay blood screening a man might get. It is no more the right of the church to deny a non-member's (or even a member's) access to birth control as it is to deny me access to blood screening. If I contributed to the health plan, then I have a stake in its application.

So if I work for a Jehovah's Witness employer, can he deny me access to blood screening on religious grounds? If I work for Brigham Young University, can they deny me coverage for an alcohol-related accident? I don't think so.

This simply has become a political football for the Republicans.