The war on contraception: Principles, compromises, and payment plans

In the nineteenth century, pr-st-t-t–n,  sometimes along with other illicit forms of s-x that couldn’t be named in print, was often referred to as “the Social Evil.”  As a way of describing our running obsession with the morality of human arousal, I much prefer this to the term “Culture Wars,” which imputes a degree of excitement to the endless sex conflict that, in its rhetorical monotony, it really doesn’t possess. Moreover, “Social Evil” is multivalent. It can mean the sex itself, or the way we think about it, or the way we try to suppress it, or the fact that we think about it at all.   I’m inclined to use it to signify the latter, but that’s neither here nor there. In any case, whenever I say “Social Evil,” think culture wars and all they contain, and let healthy images of Rick Santorum nude mud-wrestling Ellen Degeneres fill your mind.

And now that you’ve vomited: the Social Evil is back. This presidential season was all supposed to be about jobs, jobs, jobs, and suddenly it is all about sex, sex, sex. First there was the Planned Parenthood fracas.  You know about that: funding withdrawn from a major provider of mammograms because the right wing feared any medical services might somehow be infected by the proximity of abortions. Then there was furor when the Obama administration decided that employee health insurance plans offered by religious charities, hospitals, and universities had to cover contraception in the same way other employers’ would. In the middle of this, the Ninth Circuit in California dissed the opponents of same-sex marriage, holding there was no compelling reason for Proposition 8 to snatch away the right the State Supreme Court had granted. And Rick Santorum won three states on Tuesday.  The French Revolution is coming, he said, along with “the guillotine”: “if we do and follow the path of President Obama and his overt hostility to faith in America, then we are headed down that road.” Presumably the fat king and his jewel-encrusted wife will die, along with plenty of priests. (A warning to Newt Gingrich?)  The French, he went on, had a constitution that

was very similar to the American Constitution. But it was one difference. Their constitution was based on three principles. Liberty—good. Equality—good. And fraternity—brotherhood. Brother-hood. But not fatherhood.

A stiff dose of patriarchy keeps the Social Evil away.

Although pundits affect some surprise that this diversion from the Important Issue of the economy is taking place, in fact it’s not shocking at all. Culture is what Republicans talk about instead of talking about class. (They talk about race, too, but it requires more caution and so is less fun.) And culture means sex; the whole intellectual apparatus that the left-wing cultural elites try to foist on the uncorrupted masses, from nudie pictures to sweaty and shoulder-rubbing subway rides, is one giant excuse to stimulate the nether organs and jump-start nonprocreative copulation. In a year when inequality has become, against all conservative predictions, a central political issue, yelling about sex is not just a diversion for the right wing: it’s an attempt to translate an anger that most people are feeling, out of an incomprehensible language of economic justice into a vocabulary of resentment Republican leaders can understand.

The contraception battle, though, is perhaps the most revealing as far as the attitudes of the right wing go.  For those interested in the question’s legal ramifications, you can turn to David Boies (attorney and gay-marriage maven), who together with Joan Walsh explains it as “an issue of labor law, and the government’s regulation of employers (relatively minimal, compared to other countries) on issues of health, safety and non-discrimination.” The Christian Science Church may believe that modern medicine is a submission to the sinful world of materiality, but that doesn’t mean the Christian Science Monitor can refuse to cover surgery in its employees’ insurance. To make contraception a part of (near) universal health care coverage, meanwhile, is to recognize the reality that women want to have sex more often than they want to have babies. This fact is bound up with their health and well-being, as well as their autonomy. By institutionalizing the requirement, Obama has not so much promoted “broad, societal liberalization” (as Dana Goldstein wrote in the Daily Beast last summer) as brought policy into line with what’s already taken place.

This case persuades plenty of Catholics, but not the hierarchy. Catholics for Choice offers up a useful graphic: 98% of sexually active Catholic women use contraception banned by the Church.  (I like the two stylized bishops to the right, representing the other 2%; at first I thought they were nuclear warheads.)  It may then seem self-defeating that, as the New York Times points out, the US Catholic hierarchy has spent seven months preparing for this fight. But:

The speed and passion behind the bishops’ response reflects their growing sense of siege, and their belief that the space the Catholic church once occupied in American society and the deference it was given are gradually being curtailed by an increasingly secular culture.

The conflict puts not just the White House, but also the bishops to the test. Will their flock follow their lead? And are they sufficiently powerful, now that they have joined forces with evangelicals and other religious conservatives, to outmuscle the women’s groups, public health advocates and liberal religious leaders who argue that the real issue is contraceptive coverage for all women, and that the Obama administration was right?

The desire of most women to control their own bodies (along with the desire of some priests to control the bodies of little boys) has caused a catastrophic collapse in the prestige and influence of the American Catholic Church.  Trying to move the conflict to the grounds of “religious liberty” is in fact a theatrical bid to regain that power, and the loyalties of individual believers. In the process, though, the church — and the evangelicals and Republican politicians who are supporting them — show that, fifty years after the Pill was introduced, they are still unreconciled to birth control as a woman’s freedom and decision. The Catholic bishops made this clear this week. Their head lawyer said:

“There has been a lot of talk in the last couple days about compromise, but it sounds to us like a way to turn down the heat, to placate people without doing anything in particular … We’re not going to do anything until this is fixed.” That means removing the provision from the health care law altogether, he said, not simply changing it for Catholic employers and their insurers. He cited the problem that would create for “good Catholic business people who can’t in good conscience cooperate with this.” “If I quit this job and opened a Taco Bell, I’d be covered by the mandate.”

No covered birth control for anybody! Fast-food cooks breeding compulsorily the way God wanted! Santorum, a Catholic and an exceptionally candid politician, repeats at every opportunity that while “many of the Christian faith have said, well that’s okay, I mean y’know, contraception is okay: It is not okay.” But even evangelicals, who lack the Papal devotion to the dignity of the unconjoined egg and sperm, regard contraception with horror: feminism and the sexual revolution, modernity’s whole Gomorrah-bound slouch, emerged in their view from birth control’s defanging of of a principal control on sex. The war on a small provision in health-insurance policy is a war on the social acceptability of contraception — and on its recognition as a right in law.

Santorum on how birth control is bad for women

It’s in this light that one should judge the “accomodation” Obama announced today.   It lets religious organizations refuse to include birth control coverage in their employee insurance plans. But in that case, the insurers themselves must offer contraception coverage to workers directly, and cover the cost themselves. Women won’t lose contraceptive care. It’s just that their employers won’t have to pay for it.

The new policy has already stimulated wonky debate. Catholics for Choice argues that “this compromise relies on insurance companies doing the right thing.” In fact, even before Obama’s announcement, Matthew Yglesias laid out why the insurance companies will do just that:

While birth control costs more than nothing, it costs less than an abortion and much less than having a baby. From a social point of view, unless we’re not going to subsidize consumption of health care services at all (which would be a really drastic change from the status quo) then it makes a ton of sense to heavily subsidize contraceptives. … [J]ust on the dollars and cents subsidizing birth control is a no-brainer. The unfortunate thing is that under the American setup the subsidies tend to be passed through the employer, which has set the stage for this controversy.

Obama, of course, just took the subsidy cost away from the (religious) employer and landed it on the insurer. But by Yglesias’s argument, the insurers should be happy about this; the contraception costs are less onerous than the alternatives.  They might even save money, and the premiums the employers pay for other things may go down. (Others are less sure. Sarah Kliff at the Washington Post contends that somebody’s premiums will have to go up. But, according to the Guttmacher Institute, it adds up to less than $22.00 per premium to put contraception in an insurance plan. Even if the costs for a small number of religious-institution employees get spread around among the much larger number of employees who work elsewhere, the increase would hardly be crippling.)

The more interesting thing is the way Obama is grasping the moral high ground. Jonathan Cohn notes that while the US Catholic bishops are likely to reject the “accomodation,” the Catholic Health Association immediately endorsed it. (The CHA similarly split with the men in dresses in supporting Obama’s health care reform bill.)

This difference of opinion is not surprising. As a veteran health care operative once pointed out to me, health care is a reality for the nuns who run the hospitals. For the bishops, it’s more of an abstraction. And so while the former think long and hard about how to improve access to care, for the sake of their institutions as well as their patients, the bishops tend to focus more on other imperatives, like the church’s declaration that contraception is a sin.

But the right wing continues to roar, and to make it clear they want everybody exempted from the mandate to provide contraception. Four conservatives, including a former Vatican Ambassador to the U.S., condemned the administration’s

insistence that religious employers, be they institutions or individuals, provide insurance that covered services they regard as gravely immoral and unjust.  Under the new rule, the government still coerces religious institutions and individuals to purchase insurance policies that include the very same services. [emphasis added]

A Nebraska Congressman vowed to defend not just the bishops, but Taco Bell to the death: “Congress should protect the religious liberty and conscience rights of every American who objects to being forced by the strongarm of government to pay for services to which she or he has deeply-held objections.” Of course, once you let employers opt out of any coverage to which they can muster a moral objection, you’ve pretty much ensured that thousands will discover their deep religious discomfort with the extra $22 on the premium. And you’ve turned health coverage into Swiss cheese. Different holes will riddle each job’s insurance plan. No worker will have a right to much of anything.

American women are unlikely to stand for the all-out war on birth control that the bishops and their allies have opened. And even people who dislike Obamacare, and have an workplace-based insurance plan that suits them well enough, won’t want their health care infinitely exposed to a hirer’s moral vagaries. As Amanda Morcotte at Slate interprets the administration’s strategy, Obama’s been

letting Republicans work themselves into a frenzy of anti-contraception rhetoric, all thinly disguised as concern for religious liberty, and then created a compromise that addressed their purported concerns but without actually reducing women’s access to contraception, which is what this has always been about. … With the fig leaf of religious liberty removed, Republicans are in a bad situation. They can either drop this and slink away knowing they’ve been punked, or they can double down. But in order to do so, they’ll have to be more blatantly anti-contraception, a politically toxic move in a country where 99% of women have used contraception.

Last summer, a spokesman for the bishops said:  “We consider [birth control] an elective drug … Married women can practice periodic abstinence. Other women can abstain altogether. Not having sex doesn’t make you sick.” That’s their vision for women’s health (and sanity). Obama is betting that most of a modern country will resoundingly reject it.   Let’s hope he’s right.

2 thoughts on “The war on contraception: Principles, compromises, and payment plans

  1. “Not having sex doesn’t make you sick.”
    My vision for health and sanity is not that, but I think this is true: not having sex doesn’t make you sick. And I know many persons that for different reasons do not have sex and are not sick. Simply are free: more than the ones who cannot not to have sex.

  2. Planned Parenthood doesn’t do mammograms. They will tell you where you can get a mammogram, like at a real gynecological clinic.

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