This editorial will appear in Friday’s print edition.
Contraceptive use in the United States is an issue fraught with irony.
The women who can least afford to get pregnant – including the young, the poor and the uneducated – often have the least access to effective birth control. They may not have health insurance, but even if they do, it might be subject to a deductible or co-pay. So they’re more likely to use cheaper, less effective methods like condoms – or nothing at all.
Little wonder the United States has the highest rate of unintended pregnancies in the industrialized world. Almost half of all U.S. pregnancies are unplanned, and about 40 percent of those end in abortion. Medicaid and the Children’s Health Insurance Program alone spend more than $12 billion a year providing maternity care for low-income women and care for infants in the first year of life.
For millions of women – many of whom spend three decades of their life trying to avoid getting pregnant – there’s good news on the horizon. The Obama administration has announced new guidelines, recommended by the independent Institute of Medicine, requiring that all FDA-approved contraceptives be covered by new insurance plans free of co-pays and other charges.
Society has a huge stake in making every child a wanted child. Besides the financial cost of unintended pregnancies to taxpayers, experts say that children who were unplanned tend to have more health, education and behavioral problems than children whose births were intended.
But providing contraceptive coverage is problematic for some employers, particularly ones with religious objections to birth control for unmarried women or, in the case of the Catholic Church, to birth control for anyone. For that reason, the Department of Health and Human Services is offering a “conscience clause” allowing religious institutions that provide insurance to employees to opt out of contraceptive coverage under certain circumstances.
Washington is one of 28 states that require health insurance plans to cover FDA-approved contraceptives in their prescription drug plans. In this state there is no religious exemption for employers to opt out of contraceptive coverage unless they offer a plan that does not include prescription drugs.
Many states do have a religious exemption, however the HHS’s proposal is considered narrower than most. It would allow a religious organization to opt out only if it “has the inculcation of religious values as its purpose; primarily employs persons who share its religious tenets; primarily serves persons who share its religious tenets; and is a nonprofit organization” under specific sections of the Internal Revenue Code.
Opponents of contraceptive coverage are trying to water down the proposed conscience clause so employers with religious objections will have more latitude not to include it in their health plans.
While their concerns are understandable, they should recognize that failing to provide contraceptive coverage might backfire: Employers that are among the few that don’t provide contraceptive coverage might find it harder to hire and retain workers of childbearing age. Even Catholic women might have a problem with noncoverage; they use birth control at almost the same rate as non-Catholics.
It’s unclear at this point how or whether any federal conscience clause would affect the state’s more restrictive policy. The end result must be that more women have access to affordable birth control.