What is the Birth Control Debate Really About?
For the past six months, there has been regular media coverage of the so-called “birth control debate.” We have been told this is about an argument between the Obama administration and national religious leaders, mainly from the Roman Catholic Church, over whether or not it is acceptable for Obama’s healthcare plan to require all employers to provide birth control coverage to their employees.
However, that phrase, “birth control coverage” is a bit of an oversimplified way to describe the true situation here. What the Obama administration is really attempting to mandate is not simply universal coverage for birth control, but free universal coverage for birth control- with no co-pay, so that a woman would not have to pay any money out of pocket for her birth control medication.
In all of the media coverage and partisan bickering over this issue, I believe we have lost the real sticking point here- and that is this idea that birth control should be co-pay free for everyone.
This all began in August of 2011, when the U.S. Department of Health and Human Services (often referred to simply as “HHS”) announced new guidelines under the Affordable Care Act that added to the preventive services provided by the Act—in particular, expanding coverage for women’s preventive services. Some examples of these services include well-woman visits, screening for gestational diabetes, and testing for HPV, HIV and other sexually-transmitted infections. (More information on this can be found here: http://www.hhs.gov/news/press/2011pres/08/20110801b.html).
Buried in this list of services that truly prevent or detect serious diseases, we find the following listed: “FDA-approved contraception methods and contraceptive counseling”. Contraception methods? What do those prevent? What disease occurs from not using contraception?
The answer is clear: pregnancy. The subtle message here is that pregnancy is some sort of disease- some sort of unnatural, unwanted health issue that plagues women who do not have adequate access to contraception.
But is this really the right way to look at this issue? Unless a woman has a serious medical condition and has been prescribed birth control for it (a situation that certainly does occur and should not be ignored), the main reason a woman would take this medication is so that she can have unprotected sex and not get pregnant. That is not a life-or-death issue by any stretch of the imagination. In fact, it’s not even something that affects one’s life moment-by-moment. Simply put, it is only an issue for a woman who is having unprotected sex.
People have to pay co-pays for all kind of medications that are truly necessary—psychotropic medications for serious mental illnesses, insulin for diabetes, anti-inflammatories for severe arthritis—the list goes on. Why does birth control get this special treatment?
When it was introduced in the 1960s, the birth control pill completely altered society’s view of sex because, for the first time in human history, it was possible to separate the act of sex and the reality of making a baby. But the truth of the matter is, sex still does make babies. We can try to stop it, but I think we need to be honest about this part of the issue. Excluding rape, sex is voluntary, and when two consenting adults choose to engage in it, they should be aware of the possibility of pregnancy. We need to be very careful about attempting to completely separate birth control from sex and sex from babies.
Also, for the vast majority of women, pregnancy is not some sort of serious disease that has a permanent negative effect on her health. Millions of women throughout history have had babies and lived through it (in fact, many even ended up enjoying being mothers!). Having a baby will certainly significantly alter your life, but ultimately it is a risk you take if you choose to be sexually active. It seems to me that we need to take some time to reevaluate some of our attitudes about birth control, sex, pregnancy, and responsibility.
So the true argument here is not whether Catholic hospitals should have to provide coverage for birth control. It is whether a woman should be able to have as much unprotected sex as she wants without ever really having to concern herself with the possibility of pregnancy—not even so much as to have to open her wallet to get it.