![The latest skirmish in the "war on women" took place this past week in the Senate. [Credit: ACLU]](https://i0.wp.com/www.dougsbriefcase.com/blog/wp-content/uploads/2014/07/credit-aclu.jpg?resize=300%2C168)
The Senate was the scene last week of the latest skirmish in the war on women, one of several contrived controversies manufactured by the political class. [Credit: ACLU]
The habit of inflaming passions for political purposes was on display again this week in the US Senate. Wednesday’s show vote ostensibly concerned the right of women to receive “free” birth control from their employers. But the legislation, as its authors surely knew, would not become law. If it did, it would result, not in employers buying more contraceptives for their employees, but in more workers losing employment-based health insurance.
At issue was a bill to overturn last month’s Supreme Court ruling in Burwell v. Hobby Lobby. The case concerned a government edict that applies only to employers that choose to provide health coverage to their workers. Such coverage must include every method of birth control without cost-sharing. The majority of the Court determined that closely held corporations need not cover those few contraceptives (4 of the 20 FDA-approved products) to which they object on religious grounds. Their reasoning rested on the Religious Freedom Restoration Act, which provides that government “may substantially burden a person’s exercise of religion” only if it employs “the least restrictive means” of furthering its “compelling interest.”
The Senate bill to overturn this decision (S. 2578) failed on a procedural vote last Wednesday. The measure commands employers to pay for every “item or service … required under any provision of Federal law or the regulations promulgated thereunder” (section 4(a)). It doesn’t trifle with questions about whether the government has a compelling interest or even a rational basis for its dictates. Instead it confers on the federal bureaucracy plenary power to tell employers and insurers what they may and may not cover. Under its terms a future Administration could arguably ban coverage of contraceptives if it were so inclined.
The measure explicitly dismisses the protections of moral conscience contained in the Religious Freedom Restoration Act as irrelevant (section 4(b)). There is, the Senate bill declares, no constraint on the government’s power – you are to do what it tells you to do notwithstanding your moral and religious convictions.
The bill’s stark formulation betrays its political purpose. Its sponsors weren’t making a serious effort to change the law. They were trying to convince those women who tend to vote for Democrats that Republicans want to take their birth control away. Democrats fear that many of these women won’t vote in November and are seeking to provide some motivation, however flimsy, for them to do so. There’s a war on women, the bill’s proponents say. Whose side are you on?
There is, of course, no war on women and no effort to curtail access to contraceptives. Birth control is abundantly available. And the requirement that insurers and employers cover all 20 FDA-approved drugs and devices remains intact, despite the narrow exception that the Court carved out for a very small universe of companies.
Nothing in the Hobby Lobby ruling diminishes the elevated status that Obamacare extends to contraception. Coverage of contraception remains more expansive than for other preventive services for women’s health like uterine cancer screenings, coverage of which Obamacare has greatly curtailed. It is also more expansive than for drugs that are used to treat cancer (including uterine and breast cancer) and depression (including post-partem depression). The coverage requirements under Obamacare for medicines to treat these and other life-threatening conditions are much less extensive than the mandates that apply in the Medicare prescription drug program.
Enactment of the Senate bill would likely have reduced the number of people who get health insurance through the workplace. The bill’s broad mandate applies to every firm that “establishes or maintains a group health plan for its employees.” It does not apply to corporations that refuse to do so. This year, in defiance of the law [section 1513], the Administration has chosen not to impose a penalty on corporations that don’t insure their workers. There is speculation that the IRS may not levy penalties next year either. But even if it does, the penalty for not covering certain forms of contraception is 18 times larger ($36,500 per worker per year) than the penalty for not providing any health coverage at all ($2,000 per worker per year). If Congress were to overturn the Hobby Lobby decision, the only practical option left for an employer who conscientiously objects to certain forms of birth control would be to drop its group health plan entirely.
Why force that choice? If the overriding policy goal is to provide insured women of childbearing age with contraception that is free at the pharmacy counter, then why pick a fight with employers who object to certain forms of birth control? Why not make some other arrangement that would allow employees of such companies to get their “free” contraceptives without requiring their employer to pay for drugs and devices they find objectionable on religious grounds?
This is a solvable problem. But solving it would eliminate a useful political controversy. This sort of synthetic controversy has become a staple of both political parties. It is far easier to incite than unite, to conjure and perpetuate crises than to resolve them. The rewards of stirring animosity are immediate and measurable, the damage less obvious if more lasting.
But what if the President were to approach this issue differently? What if he sought a solution that both provided “free” contraceptives and accommodated the deeply held religious beliefs of a small group of employers?
That approach to leadership, so rare in both parties, might make politics less caustic and more productive.
Which, perhaps, explains why it won’t happen.