Ruminations, August 31, 2014
Religious objections to Obamacare
A major difficulty that the Obama Administration has with administering Obamacare is that they seem to little understand just how insurance works -- or that the religious objectors are serious and, perhaps, more sophisticated in insurance than the Administration is. And adding to the confrontation is the Administration’s overestimate of just how powerful that they are.
Last week, religious groups rejected the Obama folks’ latest attempt at compromise. The compromise suggested that, in order to limit the contraception premium avoidance to those who have legitimate religious objections, application would have to be made in writing. If approved, Health and Human Services would contact the insurance companies and make sure that individuals employed by the religious organization would receive contraception services at no cost.
This sounds like a perfect compromise for the Obama folks. Everyone who wants contraception care can have it regardless for whom they work and the religious organizations wouldn’t have to pay for it – or would they?
If insurance companies provide contraception coverage for individuals who are not paying for it, where will the insurance companies get the money to pay for the gratis contraception? To understand the basics of how an insurance company works is to understand that insurance companies derive their revenues – hence the source of their payments for contraception care or other benefits—from premiums paid by, in this case, the employers of the beneficiaries. So, if the religious organizations are not going to pay for contraception care directly, then they will either have to pay indirectly (premiums would have to be hidden in other premiums) or other employers would have to pay for this coverage.
The objection that religious organizations have toward contraception coverage is not strictly pecuniary -- rather, they see it as a moral objection to providing what they deem as morally objectionable coverage. Whether or not you agree that contraception care is morally objectionable, you can see the point of these religious organizations -- that they are being forced by the government to provide this care.
Even if the U.S. government were to pay for the premium out of taxes; that means that the broad spectrum of Americans – including those who find contraception objectionable – would be forced to subsidize the service.
The only viable solution, as far as the religious organizations are concerned, is to allow them to eliminate mandatory contraception coverage. Taking this step would obviously alienate the moral stand of the promoters of Obamacare to provide contraception care for all.
Ignoring the legal and political challenges to Obamacare (which are many and have not disappeared), there is a moral position to its coverage. Back before the 1980s when the increasing sophistication of computers allowed employers to offer “cafeteria” style health plans (take only the options you want), group health plans offered to employees were on a “take-it or take-it” basis – there were no choices. While there was no controversy over contraception care – it was not offered – there were some objections that religious groups had over certain procedures (e.g., blood transfusion, vaccinations) but since the plans were one-size-fits-all, people in general acquiesced. Today, while Obamacare is more flexible than the one-size-fits-all plans, it is not as flexible as the cafeteria plans with which people are more familiar. Furthermore, people who objected to vaccinations and blood transfusions were much fewer in number and had less influence than those who object to contraception coverage. And anything having to do with sex is always more controversial.
As we attempt to make things more comprehensive as we have with Obamacare, things get more and more complicated and we find more and more groups to offend. There are really only two basic solutions: more coercion or more simplification. What’s the best choice? Your call.
Quote without comment
Historian Anne Applebaum, writing in the Washington Post, August 30, 2014: “… Stalin kept to his word and carried out the threats, not because he was crazy but because he followed his own logic to its ultimate conclusions with such intense dedication — and because nobody stopped him. Right now, nobody is able to stop Putin, either. So [as in 1939] is it hysterical to prepare for total war? Or is it naive not to do so?