Solution to Obamacare's Contraception Problem Is More Obamacare
The argument that Obamacare can't force corporations to provide contraceptive coverage, which the Supreme Court on Tuesday agreed to hear, may seem like the latest challenge to the merits of law. But it's just as much a validation of one of the law's main tenets: Beginning to sever the link between employers and insurance.
At issue is whether Conestoga Wood Specialties Corp. can invoke religious freedom as a basis for not providing coverage for a full range of contraceptives to its workers, as required by Obamacare. A lower court said no, ruling that as a for-profit, secular company, Conestoga Wood Specialties "cannot engage in religious exercise." The Supreme Court will decide by next June whether that's so.
As interesting as this may be as a legal question, it's an equally interesting policy issue. Just because I believe women ought to have access to contraception through their insurance doesn't mean I support overriding companies' legitimate qualms about providing it. Conservatives aren't the only ones who believe that one group's freedom shouldn't have to come at the expense of another's.
The only thing forcing a choice between affordable contraception and companies' religious beliefs is the American tradition of people getting health insurance through their employers. The knocks against that practice are well known: Disadvantaging the unemployed, discouraging entrepreneurialism and saddling companies with costs unrelated to their business that they can't control.
Before Obamacare put health care beyond the reach of bipartisan compromise, separating health insurance from employment was a goal shared by Democrats and Republicans. "Making health insurance portable means an individual no longer will live in fear of losing his or her health care along with a job," Congressman Paul Ryan wrote in January 2010, when he was the Republicans' ranking member on the House Budget Committee. It would also mean "more options to meet the diverse needs of Americans."
Ryan's proposal was a refundable tax credit to help families buy health coverage on the open market. That isn't the same as Obamacare, which offers income-based subsidies to people who buy health plans on state insurance exchanges, but the two approaches reflect the same principle. If anything, Obamacare is the more moderate of the two, letting companies choose whether and how quickly to shift their workers to exchange-based coverage.
Fast forward four years, and the idea that Republicans and Democrats could agree on anything related to health care seems laughable. Every time a company announces that it will pay its employees to buy insurance on the exchanges rather than providing it directly, the same people who cheered Ryan's ideas seize on the news as evidence of a policy disaster.
The Supreme Court case may deepen that divide, by giving Republicans a new chance to present their Obamacare fight as a religious crusade. But it's also an opportunity to remember why the current system of employer-based insurance gets in the way of both parties' values, forcing choices we shouldn't have to make. To paraphraseFox News, maybe the solution to this provision of Obamacare is more Obamacare.
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Christopher Flavelle at email@example.com