Why should contraception be free?

[seekerz]

Originally Posted by Elizabeth502

I don't know if any of you listened to Chris Matthews' Hardball on Wednesday. I've been behaving "against type" and deliberately listening to the MSM lately, to see their reaction to Church opposition to various political issues (including but not limited to the HHS mandate). There was a segment on Wednesday's show in which Matthews introduced the rationale behind the free contraception push: according to him (and the female guests agreeing with him), the theory is that free contraceptives will virtually eradicate abortion. I'm sure that those espousing this theory look to part of the research, which does show that erratic or non-use of contraceptives among the sexually active is sometimes a matter of affordability. IOW, extremely poor women are having sex out of wedlock, and extremely poor women have lots of abortions. (Better-off women can afford contraception out-of-pocket and will in fact pay for it if insurance does not cover it.)

The problem is, it's not that simple. There are factors other than financial -- among the very poor -- that stimulate a subculture of very young unmarried sex. The affordability question may be a contributing factor excuse, but there's an awful lot involved besides affordability.

Research shows that poor, young women use contraception erratically for a variety of reasons, including poor education about it, including immaturity & irresponsibility, including hurdles to obtain it if one is under-age, including ambivalence about it if there's a subconscious wish to become pregnant for practical/emotional reasons. Free contraceptives will not resolve any of these other contributing factors.

An aside:
Research does not show that couples who use contraception consistently and correctly end up having high rates of abortion. Research shows that the unmarried, of whatever age and income level, are the category responsible for the great majority of U.S. abortions, and that married couples --both those using and not using contraception -- are the group least likely to have abortions in this country.

The bottom line is that the use of contraception is less related to income and more related to education (the research shows), and that abortion rate is less related to contraception use and more related to marital status. In any case, availability of free contraception does not guarantee its use nor (in itself) reduce abortion. The talking heads claiming otherwise on Hardball are not thinking like poor, uneducated, very young, unmarried women who have mothers just like themselves; they're thinking like what they are: highly educated, well-off women making assumptions that people of very different circumstances think just like they do.

I think you have hit the nail on the head with these observations. Unfortunately, the people taking up social issues are very often not the ones directly affected by the causes they champion, or if they are, their experience is often different from that of marginalized/voiceless segments of society. Small wonder that so many interventions fail, since they are directed at certain groups (aptly called target populations) rather than being tailored to their lived experiences. At some point it must have sounded logical to decision-makers that contraception is a solution to abortion, just as it sounds logical to international aid agencies that it is the solution to poverty. Unfortunately, life and human behavior are often more complicated than that, even for non-Catholics with no objections to birth control.

[losh14]

When basic care, as defined by the HHS (including contraception) was mandated to be free under the Affordable Care Act, I also wondered why there wouldn't either be income-sensitive co-pays, or the ability of employees and plan subscribers to elect to pay a deductible or co-pay in exchange for lower premiums. This is common now in employer-provided insurance as a cost-saver. The less the insurance company has to cover, the lower your premiums. For people who can afford to make that choice, there's no reason to play with it. This is one of the original objections to health care reform was that for those of us who like our insurance, we don't want it changed. We'd like to see everyone insured by expanding access and improving affordability where it's needed, and that should be done without tinkering with our plans.

I don't think it's unreasonable for a woman who is making $90k/annually to say she'd rather have a co-pay to save on premiums. I think it's a good idea to limit premiums for folks who are struggling.

And why should it be all plans? The AARP offers a health insurance which insures only AARP members (55 and up). Having contraception covered under AARP's insurance only increases their premiums and the underwriter's profits. And, while it's a small objection, smaller orders of priests are usually all-male. There's no reason to insure for women's reproductive services in these employers.

Originally Posted by Nate13

The underlying current to this whole debate is global warming. These people truly believe they are saving the world by passing out contraceptives and doing everything they can to help make sure people have as few kids as possible.

I've heard this too and it's amazing how much sway overpopulation/global warming/resource depletion has in this current debate. Without immigration, the populations of the US and much of Europe would be declining or at least stagnant, so the push for greater access to contraception for this reason just doesn't make sense.

Originally Posted by manualman

Snarkiness aside, here is the logic from their side:
"Everybody uses contraception and eventually sterilization, except for a few kooks. But women usually end up bearing the cost burden of buying the pills and getting the tubes tied."

The variant I've heard is "women unfairly carry the burden of sex - pregnancy, abortion, STDs - while men have consequence-free sex." I think it's an issue that men have "consequence-free sex" and that needs to be dealt with. Greater access to contraception won't change men's behaviors.

Originally Posted by LizzieAngel

I always have to add my two cents to this argument. Some women, like myself, need birth control for medical, not sexual reasons... Especially during college, $50/month for medicine is a lot of money.

That's a totally valid argument. I'm surprised that it's not covered - the recent example of Georgetown is surprising partly because the outrage was that GU would not cover birth control for therapeutic reasons despite that being the school's policy. Perhaps another, less contentious, way would be to streamline the process of getting that exemption. It honestly should be enough that your doctor writes a script that says "for therapeutic reasons" and the insurer accepts it, and any barriers to that are shame upon the insurer.

Originally Posted by turtle18

But there are so many women who have OTHER, more serious conditions and they have to pay $50 a month co-pay for their medicine.

One of the good thigns about the Affordable Care Act is that it will require coverage for certain screenings and immunizations at zero co-pay, a list of which is here:

http://www.healthcare.gov/news/facts...ices-list.html

It does astonish me that insulin isn't provided at zero co-pay or at a stated maximum co-pay, although I'm glad mammographies are. Even among health care for women, zero co-pay items are counseling for STDs but not treatment, other than HPV immunization.