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Why the Birth Control Debate Isn’t Really About Birth Control

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Last week, if you squinted your eyes and tilted your head a little bit to the right, you might have thought America had magically traveled back in time to the 1950s (or 1850s). The recent shift in the political conversation to contraception has been not only surprising but, for many, downright disturbing (bone-chilling, WTF, “what kind of documentation do I need to move to Canada?” disturbing). As the debate goes on, for me, it’s become less about religion or women’s health, and more about choice. Freedom means protecting choice—not the choice of an institution (government, church, or employer), which traditionally has power, but the choice of the individual, who often does not.
For those of you living on the international space station who missed it, I will recap. President Obama’s administration announced a policy that would require all employers, including religiously affiliated ones, to cover contraception at no cost (i.e., no deductible or co-pay) for employees in their medical plans. Religious institutions, particularly Catholic hospitals and schools, protested the mandate. Hearing the objection, Obama issued a revision that he billed as a compromise: Religiously affiliated employers would not have to provide coverage themselves, but employees would be able to arrange coverage directly through the insurance provider. Many religious groups are not buying it, and the discussion has quickly slipped from the policy itself to contraception in general. On February 16, the House of Representatives held a hearing on the new regulation. In a completely boneheaded move, the panel had not a single woman on it (there were two women in a later panel, both opposed to Obama’s plan).
Even as a dyed-in-the-wool liberal, Obama supporter, and feminist, when I heard about the original policy (on NPR, see previous statement), I thought the president had gone too far. Clearly this was an issue of government impingement on religious autonomy. I was not in the least surprised when the church objected. However, since the modified policy has been released and the furor has continued, my opinion has changed.
Requiring insurance providers to cover contraceptives guarantees a woman’s choice to take birth control or not (hear that second part, church? or not). It gives her the freedom to make choices regarding her own reproductive health. For some women, this is symbolic; they can afford to pay for birth control even if it's not covered. But for a large number of women who can’t afford up to $1200 a year, it's free birth control or no birth control. Concretely as well as abstractly, this new regulation gives these women choice. How a woman decides to exercise that choice is left to her own conscience according to her constitutionally protected beliefs, spiritual or otherwise.
From the public policy perspective, I have to say it‘s head-scratching that Republicans who constantly bemoan the welfare state are opposed to a regulation that might help reduce the number of individuals on the welfare roll (read: children born because their mothers did not have access to affordable, reliable contraception). Not to mention the economic consideration that employees on maternity leave cost companies money. Frankly, I’d like to see more talking heads examine these angles than whether, as Republican candidate Rick Santorum has said, birth control is “harmful to women." (Don’t even get me started on the guy who gleefully reminisced on MSNBC that, back in his day, women practiced birth control by holding an aspirin between their knees, i.e. keeping their legs together to begin with.)
I’d like to reframe the conversation in a way that moves it away from a women’s rights issue. The argument of religious opponents to Obama’s policy is that by covering birth control, the employer, whether directly or indirectly, would be promoting non-procreative sex, something they are morally opposed to. I have to wonder, how would the same opponents, or the aspirin dude, react if the discussion was over coverage of erectile dysfunction drugs for men whose wives were post-menopausal? Would they be equally appalled that the insurance providers they used were required to cover Cialis?
Or getting away from sex (something politicians can’t seem to do): Gluttony is considered a sin. What if insurance was required to cover gastric bypass for obese employees? (Disclaimer: I am not saying all obesity is the result of gluttony.) Would religiously affiliated employers want to deny that lifestyle-enhancing, possibly life-saving and certainly long-term money-saving medical procedure because it encouraged sinful overeating? Would it be their choice to make?
The point is that this debate is—or should be—primarily about personal choice, secondarily about healthcare and public policy, and not at all about religion or morality, at least not in the forum of government. I applaud Obama’s willingness to tackle the issue. I respect his realization that he initially went one step too far. And I support his compromise. Because when it comes to my body or my religion, all I want from my government is to protect my very personal choice.


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