Mandated Contraceptive Coverage: A Public Policy Nightmare

Every biennium, legislators introduce new mandates on our health insurance carriers, demanding that insurers pay for personal conveniences outside the boundaries of medically-necessary treatment. The contraceptive coverage mandate stands as one of the most dramatic of these proposals. It forces people of faith to fund chemically-induced abortions, puts matters of personal convenience and choice on the same level of as medically-necessary treatment, requires coverage of drugs which can endanger the safety of women, and increases insurance costs for employers and individuals.

During the 1999 legislative session, a few proponents of forced-coverage introduced Assembly Bill 362, a bill that mandated coverage of five types of contraceptives. In materials submitted during debate in support of the mandate, proponents admitted that they "prevent the implantation of a fertilized egg." In other words, they cause chemically-induced abortions.

Mandated coverage of surgically-induced abortions could well be next.

Medically speaking, when a mother's egg and a father's sperm join, a new human being is created. Utilizing a chemical drug to block the tiny baby's ability to attach itself to the mother's uterine wall kills the child. It can come in forms such as "the Pill," "Norplant," "the Morning-after Pill" and "Depo-Provera" - each can end the life of a newly-formed human being. People of many varied faith groups support the right of a child not to be killed via an induced abortion. To this end, I joined many other legislators to adamantly oppose forced coverage of these abortion-causing drugs.

While abortion continues to serve as a controversial topic in American culture and politics, statistics demonstrate that an overwhelming number of people do not support abortion on demand. In 1999, for instance, a survey of Wisconsin residents showed that 66% opposed abortion on demand for any reason other than rape, incest or the life of the mother. While 19% believed that abortion should be legal within the first three months of a pregnancy, an equivalent 19% said that abortion should never be allowed under any circumstance. Thus, government-mandated coverage of abortion-causing drugs does not comport with the attitudes of at least two-thirds of the people in Wisconsin.

Forcing everyone to pay for contraceptives violates individually-held religious beliefs of many Americans. It also directly affects insurance companies sponsored by religious organizations. As an example, Catholic insurance companies would have to violate the closely-held tenets of their religious beliefs under such a mandate, or, in the likely alternative, stop offering medical coverage completely. We could also expect future legislation requiring hospitals and pharmacies to provide contraceptives as part of their medical care. Those linked to a church may choose to close their doors in order to avoid providing a state-mandated benefit. Elimination of medical coverage, and eventually medical care, by faith-based or religiously-oriented organizations could lead to a public health crisis, in addition to the taxpayer-funded litigation that would follow.

Aside from the moral and religious objections to forced coverage of abortion-causing drugs, there's also the practical argument against such a policy. Birth control for personal convenience is not medically necessary.

We do not mandate coverage for massages, health spas, exercise programs, aspirin for minor headaches, or acupuncture - even though each makes our lives more comfortable and provides health benefits. As a society, we recognize these items as personal conveniences that each individual chooses to take advantage of or forego. When individuals choose personal conveniences, they also bear the financial responsibility of having made a conscious choice to buy these optional goods.

Unlike personal convenience items, birth control is not safe for every woman. After suffering injuries, 300 Wisconsin women received a court settlement from the manufacturer of "Norplant." Medical studies also show that women who utilize prescriptive contraceptives are at an increased risk for acquiring chlamydial infection. In addition, a Los Angeles-based study associated use of "the pill" among young women with an increased risk of breast cancer.

Of course, the economics of mandates speak volumes against such a proposal. When insurance companies are required to cover widely-used conveniences, the cost of health insurance rises. In fact, according to the proponents of 1999 AB 362, for a company employing 500 people, the new required benefit would cost the company and its employees over $10,000 per year. That's a large expenditure, especially when America may be facing an economic downturn, and HMOs are levying increases of 15% to 70%. If companies are forced to pay thousands of extra dollars annually to cover personal conveniences, they will likely eliminate jobs or insurance coverage; thus, fewer people will receive coverage for medically-necessary treatment such as prenatal care, mammograms and childhood immunizations - each of which are far more important than contraceptives.

In the end, mandatory birth control coverage equals bad public policy.

It decreases the chances that health insurance will remain affordable and readily accessible for working class families, forces people of strong morals and faith to pay for drug-induced chemical abortions in order to receive health care, places personal convenience products on a par with life-saving medical technology, sets a precedent for further mandates in the future, and takes us one step further as a society down the path of devaluing human life.

Along with a bipartisan majority of legislators in Wisconsin, forcing coverage of contraceptives onto the public remains a poor public policy choice I'm unwilling to support.

February, 2001