Nancy Pelosi made her wrenching choice between the health reform bill and abortion rights, and—unless Obama works some magic soon—American women will have to live with it. Since the House bill passed with just two votes to spare, the anti-abortion language in the Stupak amendment may have been essential for passing it. (The Catholic leadership, which had lobbied heavily against abortion funding all summer, gambled, correctly, that, despite Pelosi’s commitment to abortion rights, she wouldn’t abandon the bill on principle. The same, it should be noted, cannot be said of the bishops, who were willing to kill the whole deal—pediatric services and all—if all of their own demands were not met.)
Abortion, it seems, was lost to political horse-trading. But there are also deeper forces at work that will continue to affect the 10 million women who are expected to participate in a health care exchange—an infuriating irrationality that taints not just abortion, but many other health issues that are perceived to be connected to women’s sexuality.
The best example is birth control, which was also recently thrown under the health-reform train. So far, none of the three reform bills has required insurers to cover contraception, although it is almost universally used by heterosexually active women. Other preventive services, such as some counseling about sexually transmitted diseases and pelvic exams, didn’t make the cut, either. Nor have the bills protected these services from “cost sharing,” which means that women may well end up paying for much of their birth control out of their own pockets.
Women’s health advocates reported that some Democrats cited a fear of igniting controversy when asked to insert birth control and other preventive services for women into the minimum benefits package. What’s the controversy, exactly? It seems birth control has become a suddenly loaded political issue, a toxic sister to abortion, somehow resonant of irresponsible sex and women’s bodies. And this time around, no one wanted reform to collapse under the weight of special interest groups’ requests, as the Clinton effort did in 1993. Ultimately, people fell back on budget concerns. Adding to the list of services insurers must offer would have given the bill a higher score from the Congressional Budget Office—and made it more vulnerable to attack from budget hawks.
But there was certainly no medical justification for excluding contraception from a list of services to be covered without co-payment, which included newborn care and pediatric vision services. Surely fertile women don’t represent a “special interest group,” since the overwhelming majority of women—including more than 80 percent of Catholics—use birth control. For most, the need is chronic, which helps explain the fact that, even though most plans now cover contraception to some degree, women already pay more than men out of their own pockets for health care. To wind up with two children (roughly the average family size), most women need to use contraception for about three decades.
Most doctors understand the importance of birth control: Women who use it have lower rates of infant and child mortality, more time to nurse their children, and a smaller likelihood of high-risk pregnancies and anemia. More than 38 million women are currently using some form of it, according to the Guttmacher Institute, which conducts research on reproductive health. And almost all sexually active women use birth control at some point.
Yet despite its widespread use and acceptance, lawmakers don’t see birth control as the fact of life that it is. Even though politicians are—or, at least, presumably were at some point—regular people, they pretend that something most women have used as a matter of course is a moral issue, and a politically radioactive one at that.
If you ask a pro-life activist what exactly is objectionable about birth control, you’re likely to launch a discussion about when life begins. That’s because much of the opposition to contraception that’s sprung up over the last decade or so has been hitched to the idea that specific methods are tantamount to abortion. In this mindset, the IUD, oral contraception, and the “morning-after” pill are essentially abortifacients, since they may prevent the implantation of an already-fertilized egg—a life, in their view.
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Comments
It's all about control
By: Free Cell Phone Spy | Tue, 02/09/2010 - 08:29
The fact that so many people on the rational side of this debate don't seem to see is that being against abortion and birth control is all about control. The only reason "right-to-lifers" want to control other people's reproduction is because they can. If they could not, I guarantee you there would be no politics of reproduction, and hardly a peep about "morals". Don't believe me? These people claim they believe law is all about the ten commandments, but why aren't they out there harassing us all to honor our parents all the time? Because there is no way to legislate it. If abortion/birth control could not be legislated, it would not be considered murder.
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This doesnt surprise me !
By: jminned10 | Sat, 01/02/2010 - 17:37
Everyone these days just tries to rip each other off! Im not surprised with the high cost of health care that someone doesnt get a service that is great for population control. When I go and play bingo I see tons of young pregnant women. Birth control should be provided free from the government.
With an affordable healthcare
By: Mikee_L | Thu, 12/03/2009 - 04:37
With an affordable healthcare system, real economic and social gains will be realized by every American individual. But unfortunately, those gains are not that easy to realize. Health care costs in the United States exceed those of any other nation. Millions of Americans are uninsured, partly because of rising premium costs, and more and more, they resort to payday loans to finance both emergency and routine medical expenses. With health-care reform issues taking the political center stage, is this not a good time to step back and assess the problem from a more basic point of view? Is it really possible to have a healthier society and more effective medical care without, first and foremost, reducing the need and thus the demand for medical treatment?
maternity coverage v. Viagra
By: Kati | Tue, 11/24/2009 - 14:51
I'm late commenting but I can't help myself.
Health insurance no longer covers birth control, it will no longer cover abortion, and 60$ of private health insurers do not cover maternity costs...
But they do cover Viagra for older men, while opponents of birth control (starting with the pill and onward to all other methods) argue that sex shouldn't be contemplated outside of wanting to have a child. But they don't oppose Viagra? Give me a break!
In the meanwhile we have rates of miscarriages by women who do want to carry their pregnancy full term and of infant mortality that rival some Thrid World countries. This is of course due to women being denied medical care during and after pregnancy, but also BEFORE, the sort of gynecological care provided to women who are uninsured or not getting it through their health insurers by Planned Parenthood clinics... The hypocrisy is enough to make you puke!
Birth control not covered
By: women make news | Mon, 11/16/2009 - 12:14
Thanks for telling us what else got left out of the h.c. bill--I didn't realize that.
So far, none of the three reform bills has required insurers to cover contraception... counseling about sexually transmitted diseases and pelvic exams....
Funny, I had thought we already had this battle in many states about making insurance companies cover b.c.
It's amazing that this could happen. No help for b.c, abortions, or welfare after being bascially forced to have a child.
What is up with that?
BCPs do not prevent ovulation...they only attempt to do so
By: MIWoman | Mon, 11/16/2009 - 11:19
To the commenters that say the pill prevents ovulation so has no abortifacient qualities - that is simply inaccurate. Read the insert that comes with your BCPs. It clearly states that the pill has three methods of action: 1) it attempts to prevent ovulation; 2) it thickens cervical mucus to inhibit sperm motility; and 3) it changes the endometrial lining of the uterus to make is less likely to support an embryo.
The pill does not ALWAYS prevent ovulation, not even when taken correctly. The levels of estrogen in modern doses of the pill have been drastically lowered from the days when the pill was first introduced to the market. This reduced level of estrogen helps reduce the likelihood of severe side effects (blood clots). The side effects are still there though, and for some women are quite severe.
Basically, the pill is attempting to prevent ovulation, if that fails (which it is estimated it does approximately >25% of the time), the built in "back up" methods are to inhibit sperm motility (thicken cervical mucus so sperm cannot reach a released egg) and to make the endometrium inhospitable to an embryo trying to implant (reduces the build up of blood vessels to the uterus to thin the lining).
As much as we'd like to pretend it isn't, for some people it is a huge moral issue. I think those people have every right to know how the pill works so that can make the decision to use it or not to use it themselves. If a person believes life begins at fertilization of the egg, then the pill could present some moral dilemas for them. If they believe it begins at conception (medically defined as implantation), then it may not have moral implications for them. If they believe it begins when the fetus is born, again, it may not have moral implications for them. Each person has to decide that for themselves.
As for my opinion on insurance covering birth control pills. I don't think it should. I don't think insurance should cover anything routine. My car insurance doesn't cover getting new brakes put on my car, but it would cover my vehicle in case of an accident if my brakes went out. I think the same principal should apply to health insurance. General maintenance items and preventive measures, annual physical, birth control, multi-vitamins should not be covered.
The Birth Control vs. Viagra Argument
By: RogerDavidson | Sun, 11/15/2009 - 18:11
I think birth control should be covered by insurance.
Angrily equating birth control for women with Viagra for men doesn't help this cause. Women and men are the opposite sides of the same coin. Alienating men with the Viagra argument won't help. Being a victim, bearing a huge cross, and pontificating from a high horse isn't the correct way to win the battle for hearts and minds.
This mode of arguing is no different than the men who say things like "In a case of an unplanned pregnancy, it is unfair that men have no choice as to whether the baby is born or aborted (victim), because the man's financial future is at stake (bearing a cross), and also because it's an equality issue (high horse)."
The best argument is the cost/benefit one.
It should be noted that there is often a hint of racism in much of he anti-birth control wing; while it is never openly said, you can all but hear some people mouthing, "if poor minorities are having babies, rich white women better keep up!"
pill not medical
By: PAmom | Sun, 11/15/2009 - 12:16
Great! The pill is not a medical necessity, not even medical at all, you say. Just a lifestyle choice. I could not agree more - so could we please just buy it off the shelf just like in ever other civilized country? I brought home 23 packs of pills at 1/10th the price last time I went to France, all without needing to call my doctor's office, beg for an Rx refill, set an appointment and pay the co-pay, call in the prescription every single month to the pharmacy (we're not allowed more than one month supply at a time). I would LOVE for this not to be medical!!!
@vim876
By: janneys2005 | Sun, 11/15/2009 - 10:49
Did you even read my comment? I mentioned all of those things.
The difference between viagra and birth control is, for men with ED, they can't have sex at all without viagra. Can you have sex without birth control? You sure can. And even if you argue you can't safely have sex because of pregnancy, you don't HAVE to choose hormonal contraception to avoid pregnancy when you do have sex. There are, literally, a dozen other options. For ED, there is no other option. That's a huge difference.
You mention that pregnancy is a medical condition. And yes, if you get pregnant, I am sure it will be covered.
Also, I very clearly stated the exception for "birth control" used for medical purposes. That is not part of the argument. We are discussing coverage for the pill for contraceptive use. By the way, it's not called birth control when it is used for a medical purpose. It is hormonal therapy.
Finally, the difference between the pill as contraception and the pill as treatment for disease/viagra as treatment for disease is the pill AS CONTRACEPTION is elective and the other two are not. Just as most insurance would cover a breast reconstruction after mastectomy but not necessarily cover breast implants as an elective cosmetic procedure for an otherwise healthy young woman. You may not agree with the distinction, but it is definitely there when it comes to arguing about birth control coverage - you can either find ways to work around this, or continue harping on the same tired arguments (which are obviously not working).
"If birth control is a
By: total_realist | Sat, 11/14/2009 - 20:40
"If birth control is a lifestyle choice, why isn't viagra?"
erectile dysfunction is a disease or disorder. it means something about the body is malfunctioning. fertility is the OPPOSITE, it means the body is functioning in a healthy, normal way.
yes, birth control should be covered by health care plans, in my opinion, but making these illogical comparisons will not get us there--it will just make people not take the issue seriously, unfortunately. let's make the good arguments instead.