A Fight Over Contraception Won't Help Obamacare
Two employers who have religious objections to the contraception mandate recently had their cases granted cert by the Supreme Court. I gather that both supporters and opponents of the mandate think the Supreme Court will probably rule that corporations (at least closely held ones such as these two) are going to be granted an exemption from the mandate if they have clear religious objections.
Social media was on fire over this when it happened, and I confess that I am struggling to see why. There was a lot of outraged talk about how corporations aren't people, of course, but a lot more about employers trying to control their employees' sex lives, treating women as second-class citizens and so forth. To judge from these reactions, you would think that birth-control pills were a scarce resource that could only legally be obtained through employers. In fact, generic birth-control pills are available for $25 a month through a Costco pharmacy, $50 if you want a brand name.
"But that's expensive for a young woman on a budget!" you are about to cry. And I am about to answer that it doesn't get less expensive because an insurer buys it. Regular, predictable expenses such as birth-control pills cannot be defrayed by insurance; they can only be prepaid, with a markup for the insurer's administrative costs. The extra cost is passed on by the insurers to your employer, and from your employer to you and your fellow workers, either by raising your contribution or lowering the wage they are willing to offer. There's obviously some cross-subsidy from your fellow employees who don't use birth control, but overall, there's no particular reason to force insurers to cover a minor and predictable expense.
The administration didn't force employers with a religious objection to offer contraception because it made financial or medical sense; they did it because it had great symbolic value to Barack Obama's political base. And much of that symbolic value seems to actually come from the willingness to coerce people who object to buy the stuff. You can imagine that in an intra-left debate over what mandatory services should be covered, some of the people now professing outrage at Hobby Lobby Stores Inc. (one of the parties involved) would see the logic of ditching birth control if it lowered premiums by $15 a month and thereby increased access.
But, in fact, if you want to make the Patient Protection and Affordable Care Act viable for the long term, you're going to need the support of folks like Hobby Lobby as much as you need low premiums. There are many religious people in America, and if you want to keep stirring up active opposition to the law, one good way is to suggest that this law forces them to pay for something they are convinced is morally wrong. (Hobby Lobby's objection is not to contraception in general, but specifically to products that could prevent a fertilized egg from implanting.) If you want to still be fighting Obamacare in the trenches 40 years from now, the best way I can think of is appending it to the argument over abortion.
I understand that you may think Hobby Lobby's position is ridiculous, or that contraception is a fundamental human right, but here's the problem: Hobby Lobby's owners, and millions of other Americans, hold the opposite opinion at least as strongly. In a pluralistic society, they have the right to fight you on it every step of the way. To state the obvious, Obamacare is probably not going to survive many more such battles.
If the administration loses in the Supreme Court, that will be good news for religious liberty, but also good news for Obamacare. Right now, the administration needs to pick its battles carefully. This should not be a hill they're willing to let the law die on.
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Megan McArdle at firstname.lastname@example.org