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Our Fears Are Realized



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Lost amidst the excitement over the negotiations over the debt ceiling was the fact that on Monday, the Obama administration announced that under Obamacare, health insurance companies will be required to cover contraceptives. Unfortunately, the thorny issues I blogged about earlier still remain. Will minors be able to obtain birth control without their parents’ permission? Additionally, even though some conscience protections have been put in place, there are questions about whether the conscience rights of physicians who do not wish to prescribe birth control will be protected. It also appears that contraceptive coverage will include ella, which sometimes works as an abortifacient.

Broadly speaking, it also shows that many of the concerns that conservatives expressed about Obamacare are now being realized. First, this provides ample evidence that decisions about health-care coverage will be driven by politics rather than policy. Pregnancy is not a disease. Additionally, there is little evidence that people lack access to contraceptives. Finally, there is no body of peer-reviewed evidence which shows that funding of contraceptives or mandated coverage of contraceptives reduces either abortion rates or the rate of unintended pregnancies. All in all, it appears that President Obama’s political allies at Planned Parenthood just received a nice bailout courtesy of the federal government.

Second, important and controversial decisions about health policy have been removed from the democratic process and are now being decided by administrative fiat. The Obama administration cleverly hid behind the figleaf of the Institute of Medicine’s recommendation to cover contraceptives. However, the positions taken by professional and academic organizations typically reflect the preferences of the most active members — not scholarly consensus or the best research. Furthermore, decisions made by professional groups are often subject to political considerations. All, in all, this outcome should come as no surprise. Many on the left — including abortion-rights advocates — typically try to achieve their policy objectives via administrative or judicial fiat — instead of the democratic process.

Michael New is an assistant professor of political science at the University of Alabama and a fellow at the Witherspoon Institute in Princeton, N.J.



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