Contraceptive Coverage in US Health Care Plans

The fact that, in the USA, having decent basic health insurance for all is dependent on some funny scheme involving employers is something that most of the “civilized” world finds hard to understand. But given that it is so dependent, thinking about the cost impact of paying for contraception as opposed to the alternative raises an interesting point about whose “freedom” is at stake when the catholic bishops insist on being able to exclude it for their employees.

Health insurance companies which are free to charge on a cost-plus basis have no incentive to require a cost-reducing preventive medicine if they are free to charge whatever the costs are without it. But If I was selling dependent coverage at a fixed rate independent of family size (as many group plans do), then I would probably be prepared to add birth control for free after negotiating the rate without it – unless of course the employer told me not to. So what may well be the case here is that the church was seeking to pay a premium for the right to *exclude* contraception from a plan which could have been cheaper with it.

If so, then the church has been making all this fuss because they want the freedom to pay extra themselves in order to deny their employees the freedom to get whatever birth control they need via the most economical route. If people can understand this (and if the media don’t suppress it) then it will be interesting to see where the mud finally sticks!

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