Should the New Health Care Plan Cover Birth Control?

The welfare state is ratcheting up. Can we afford not to provide publicly funded contraception?

Birth control is a hot button issue. It’s availability to the masses is more than a political matter; it has far-reaching economic consequences in a welfare state. When it comes to government-financed contraception, people land all over the map. So, should the new health care plan cover birth control?

Posing the question isn’t just for kicks. There is a movement gaining steam to provide free birth control as part of the Affordable Health Care Act. The White House issued new rules as a part of health care reform requiring health insurance companies to provide access to routine preventative care at no cost to members. That means no co-pays regardless of where your insurance comes from: employers, the government, or individual policies. Now women’s health advocate groups, including Planned Parenthood, and even some employer groups believe contraception should be added to the list and deemed preventative care.

The Department of Health and Human Services, led by pro-choice Obama appointee Kathleen Sebelius, will spend the next 6 to 18 months researching women’s health before determining specific guidelines for women’s “preventive health care.”

It’s clear that most sexually active women would love to have “free” birth control as long as they can. I’ll throw up the quotes around free one time, as long as we remember that nothing which comes from the government is free. It costs taxpayers and has opportunity costs beyond that. For you girls and women in Planned Parenthood, this just means your parents, grandparents, teachers, bosses, co-workers, friends, and neighbors are paying for your contraception. If economics can teach us anything, always be cautious with the word free.

Currently, public initiatives offer free, or heavily subsidized, birth control in some states through organizations like Planned Parenthood. With most state budgets in the tank, these options may not be there forever. Some religious groups scoff at the idea of publicly-funded birth control as it flies in the face of their spiritual beliefs; and more seriously, public financing for abortion. We can save abortion for another day, however, it’s safe to say you won’t find too many public health experts on the platform that distributing birth control is a bad idea.

One such religious voice chimed into this debate. Deirdre McQuade, the spokeswoman for the United States Conference of Catholic Bishops, stated, “Fertility is not a disease to be cured, and the government should not treat it as that.” So presumably, Mrs. McQuade is against publicly-funded birth control. With closer examination of the Catholic Bishops website, one reads that “natural family planning” is the term for their method of choice. This means husbands and wives engaging in intercourse during the least fertile points of a woman’s cycle, without contraception of any kind. Fair enough Catholic Bishops, but this is where things get dicey. We live in a country of socialized costs, with welfare rolls, bailouts, public retirement funds, and public health insurance funds. The scope of our welfare state is only growing with new government initiatives, expansion of old ones, and a growing (and aging) population. Our regulated capitalism/socialism experiment has tipped further in the socialism direction. Add in a broke or bankrupt society at local, state, federal, and consumer levels, and we have a problem brewing here.

The religious ideals of Mrs. McQuade unfortunately do not mesh with the reality of the current economic and political climate. The day health care was socialized was the day I now had a financial stake in my neighbor’s lifestyle choices. Maybe I should be inspecting the neighbor’s trash for fast food wrappers, and if necessary, picketing their front lawn for nutritional change. I’ll be forking over the dough for their future diabetes and triple bypass anyway, so there are certainly worse things I could spend my time doing (watching 16 and Pregnant comes to mind).

When 13 to 25-year-old females have children, what is the impact to the welfare system? A lot of estimates are out there from places like the Bureau of Labor Statistics (BLS) National Longitudinal Studies to individual groups. What I think we can all agree on is that the impact isn’t good. While fertility is not a disease, public bankruptcy is. This is why I would advocate public distribution of contraception, and for girls up through the age of 25…at least. Now, I would also advocate for a welfare state a fraction of its current size and future trajectory. But as long as we’re all on the hook for one another’s poor decisions, we must spend money up front to prevent sizable cost anchors in the future. As public utility goes, planned pregnancies have been shown to be healthier for both the mom and baby. As far as religious beliefs are concerned, I’m sure that abstinence is the solution offered for unwanted pregnancy among unmarried couples. While a perfectly fine belief for a private individual, family or organization to have, it’s not a realistic public initiative. Even if it were possible, I don’t know that I want to live in a world where all unmarried people aren’t having sex. Tension would be at all-time highs. Further, natural family planning between married couples ignores the fact that humans have premarital sex. As long as we’re a welfare state, we can’t ignore facts.

The National Business Group on Health commissioned Price Waterhouse Coopers to study the estimated cost to health plans of providing preventive family planning services. The study determined that the cost is about $40 per member annually. These are, of course, private plans looked at in the study. However, if you wanted to tax me $40 extra each year to help prevent many, many pregnancies, I’m all in.

In principal I believe people should shell out their own cash to practice safe sex. The financial consequences of not doing so should also be shouldered by the individual alone. But my beliefs (wishes) don’t really hold water in real life. Some people are literally too embarrassed to go and buy condoms in a store from a stranger; while, simultaneously, unwilling to be abstinent. I guess playing baby roulette is more fun. Some people tend to rely on others when they should rely on themselves. People act recklessly at times, too, no more so when under the influence. And, shockingly, sexually active teenagers tend not to be reliable either.

So the government should pay for birth control, and for the right reasons; not because women have to shell out loads of cash over the course of their lives. According to MSNBC, the average woman spends “roughly 5 years trying to get pregnant or being pregnant.” Compare that to the roughly 30 years she spends trying not to have babies. If women want to have sex while not having children or contracting diseases, they should be expected to pay for it themselves. Men should also have the same expectation for personal responsibility, although the pregnancy thing isn’t quite parallel. At least that’s what I’ve gathered. Even though we should be responsible as individuals, some of us inevitably won’t, and all of us will pay for it in the current entitlement/welfare framework.

Religious groups should not get in the way of government-financed birth control. If they do, then they can take over the welfare rolls, which consequently, is a core mission for some of them anyways (taking care of the downtrodden).

To tie a bow on this, the government should finance birth control; not because we are our brother’s keeper, but only as a result of engaging in entitlement programs to the degree we do. In other words, government should finance birth control, not because we are our brother’s keeper, but only as a result of engaging in entitlement programs to be our brother’s keeper. When it comes to publicly funding contraception, we can’t afford not to.

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16 Comments

  • No! Does car insurance cover oil changes? Does home insurance cover yearly heating checkups?

    As a 30-year veteran of the health care industry, our health insurance should cover preventive and major medical benefits only. Wait! That sounds like an HSA?

    Maybe the reformers should have looked in that direction>

    • Normally I would agree with you. In fact, I’ve written many articles about how our “health insurance” isn’t really insurance at all; it’s a pay-for-the-lion’s-share-of-everything plan. If we are to reduce health care expenditures, patients must shoulder more of the costs. See the following articles:

      1) http://www.swifteconomics.com/2010/05/06/health-insurance-conundrum/

      2) http://www.swifteconomics.com/2010/07/16/identifying-health-care-problems-and-solutions/

      However, we’re operating in a welfare/entitlement state which is spiraling out of control. The population is growing and aging. Not allowing people to have free or cheap access to the most effective and reliable birth control methods would be foolish in the current system. We all have considerable stake in one another’s lifestyle choices because we foot the bill for them. When it comes to publicly funded contraception, either we scrap/significantly reduce the welfare state, or we provide contraception for people. Anything else would be disastrous considering our population demographics, future growth, and the current welfare/entitlement system.

  • Scam


    While I understand your point Ryan, I have to disagree with you on this one. One example why is because people use your same logic to argue for more government control over what we are allowed to eat. Candy/soda taxes and trans fat bans are deemed reasonable because “we all have to pay the costs of obesity”. Big government should never be an excuse for bigger government.

    It would also be interesting to see just how many unplanned pregnancies publicly funded birth control would prevent. It wouldn’t change my mind but I like to see actual numbers when it comes to costs.

    • Yes, the same logic applies to things I’d rather not see happen e.g. the food police. It’s the slippery slope argument, except we’ve already slid halfway down the mountain. I’d like the welfare state to be scrapped/significantly reduced. I’d like people to shoulder the costs of their own decisions. I’d like people to be free. But we don’t have that system currently. We will need many new leaders to make even strides back in that direction. In the meantime, we still have socialized costs in the form of corporatism, bailouts, welfare, national health insurance, and national retirement. Give me freedom, and I’d back off the ledge of publicly-funded contraception. Give me transfer payments and inflation over time, and I think it’s the only logical thing to do.

      Big government isn’t my excuse for the contraception. Financial realities, as a result of years of big government, is. Whenever the state takes money from a private citizen, it is immoral. I completely agree with that. But that’s what our system runs on. You can pay for the contraception now, or pay more later in the form of welfare and entitlements. And we’re already on an unsustainable path.

      Reliable, meaningful, and current numbers on unplanned pregnancies, particularly their impact on the welfare system, were hard to come by. I’d like to see some specific studies as well.

  • Andrew


    It reminds me of Ludwig von Mises’ argument that government intervention begets more government intervention to fix the unintended consequences from the previous intervention, ad infinitum. This is a hard one for me. I can see the consequentalist logic to having the government pay of birth control under our current system, but morally, it’s hard to justify.

  • Scam


    I guess it would be safe to assume that most of these unplanned pregnancies would turn into net takers from the government. However, so are most immigrants. Would you be in favor of restricting immigration? I myself am a huge believer in the value of human capital, even of low skill workers, which is one of many reasons I believe in open borders. I guess I’m wondering what the contrasts between these two groups would be.

    • Immigration is one input into population growth, which I had in mind when discussed in the article. While I’m all for legal immigration, the influx of foreigners into one of the freer and most prosperous nations on Earth only strengthens the argument for contraception from a welfare/entitlements standpoint. I’m a believer in human capital, too. But I also would like Phoenix, AZ to not produce the second highest volume of kidnappings in the world. Open borders plus illegal drugs isn’t working out too well. Legalize drugs and bring the cartels above ground, and open borders makes a lot more sense. America attracts some of the best talent from around the world, as well as hard-working low skill labor. Immigration is great for both parties. But I would like it to be orderly/safe in our “sovereign” nation.

  • Scam


    “Open borders plus illegal drugs isn’t working out too well.”

    Well you’re halfway right. Illegal drugs isn’t working out too well. However, I highly disagree that there is any such thing as open borders in this country. There should be tho. If you’re able to understand that legalizing drugs would be a positive thing, than you should also be able to see that legalizing immigration in this country would also be a solution to many problems (it would be the only way to make immigration “orderly/safe”). Legalizing either would be a step in the right direction, and you don’t need to do one in order for the other to make sense either. I’m pro immigration whether it’s being done legally or illegally. And for many of the same reasons, I am not worried about too many babies being born.

    • Well, we have immigration laws, so no, our borders are not “open”. But they’ve proven to be relatively easy to cross for a sovereign nation supposedly enforcing immigration laws. That’s all I meant. If we had open borders, you are right that it would be safe.

      The whole focus of this article is the welfare/entitlement state. You’ve conceded the point that most of these unplanned pregnancies would turn into net takers from the government (aka taxpayers). Then you say you’re not worried about too many babies being born. The article is pointing out that the welfare/entitlement state needs to be significantly reduced, or there is good reason to be worried from a fiscal perspective (not to mention that unplanned pregnancies in welfare families doesn’t always yield the best living conditions). Population growth, whether in the form of births or immigration, will contribute to the current system becoming insolvent. David Walker has already projected it is headed toward insolvency. You haven’t really addressed that, which is the thesis of the column. Open borders would have its costs and benefits, which really should be for the individual to sort out. But open borders would be a fiscal disaster if welfare/entitlements were not reformed.

  • Scam


    I’ve conceded that they will, on the whole, receive more money from the government than they will pay directly to the government. I have not conceded that they will not be, overall, a benefit to the national economy. However, even if that were the case, I would still hold the same position based on moral grounds. I think it comes down to the fact that I don’t think the end justifies the means, whereas you do.

    • I have similar beliefs as you, as far as the moral grounds of government intrusion and the notion of freedom. I don’t necessarily agree that it is immoral to have a sovereign country. I would like a free nation with minimal government if it were up to me. But I’m also a pragmatist and a realist of our current state. I acknowledge the system we have today. I’m all for working toward reversing that fact, but that will take time, if it ever comes to fruition at all. You say the ends justify the means for me; I say it’s working with the system we have. A person can disengage or try to work outside the system, but neither will be all that fruitful.

      I respect your point of view; it’s basically my point of view. But you still didn’t address the welfare/entitlement impact from population growth on our fiscal health. You’ve said that you believe immigrants, as a result of human capital, may be a net benefit to the economy (and either way you’d hold the open border position on moral grounds). How’s the economy going to be doing with welfare/entitlement spending sending us toward bankruptcy? That’s the question that has to be answered because that is the plane we’re on.

  • Scam


    When discussing policy with friends they often respond to my ideas by saying, “That’s nice, but how about providing a realistic alternative.”

    The truth is I don’t have many ideas that actually have a shot of being implemented anytime soon. If we look at your suggestion tho, how much difference would it really make? If we do have less babies being born and we do restrict immigrants, how much will that really slow our journey to bankruptcy? It’s certainly a very temporary fix. I don’t have anything to back this up, but I can’t imagine it would delay things very long at all. It seems the only way to make a real dent is to have someone in office willing to slash spending. Welfare/entitlement isn’t the only area that could use some spending cuts remember. Who knows, maybe our next president won’t feel the need to have a global military empire. (Is Ron Paul our only hope?)

    • My suggestion isn’t a complete policy. It was a narrow look at one issue: should birth control be covered by the Affordable Care Act? I’m for everything you mentioned e.g. slash spending across the board, reduce the size and scope of government, stop corporatism/bailouts, reel in the military, and reform welfare/entitlements. I’d like to see the tax code get scrapped and a fair tax implemented.

      I don’t really expect meaningful changes to be made anytime soon, only more temporary stopgaps and socializing costs through the debt and monetary policy. My suggestion would hopefully buy some time before fiscal disaster. Maybe it’s too late, though, and it wouldn’t matter. Who knows.

      Ron Paul is one of our only hopes. I was very disappointed to see Peter Schiff lose the Republican nod for US Senator in Connecticut. We’re going to need more than one or two people to step up, and it’s probably going to need to be from both parties plus a few independents. I hope that sometime in my lifetime another major party rises to break up the political oligopoly, and provide another path.

  • Jerry Sader


    Free birth control was compared candy/soda policing. I wanted to point out that this is not a good comparison because there is a huge difference between offering and restricting. If the taxes are already stolen or the money is already printed offering something for free isn’t as bad as limiting ones free choice. I’d prefer to live in a free society but I’d pick a socialist country over a fascist one!
    And how about I offer up a controversial idea! Taking welfare payments from the government is optional, right? So why not have the government require that when you pick up your welfare check (I realize it’s done automatically in many places now) you get the birth control shot if you are a female (and if they develop a shot for males they do the same). Basically, if you take our money…no getting pregnant! Of course once you are off welfare you will be fertile again (please ignore the fact that current shots make some people sick and such…this is only hypothetical because it would be political suicide to implement).

  • cioara


    Everyone already has access to birth control, mandating that all insurance companies offer it with ZERO co-pay simply means we’ll all be paying more for a benefit even if we don’t want it or don’t need it. In a word, socialism.

    On the other hand, to stop unwanted pregnancies and disease is the right thing to do and I bet is a wise economic decision for prevention. A ounce of prevention is better than pound of cure. Lets keep our demcratic republic not a theology state. Keep religion out of government and government oout of religion.

  • JG


    You of all people should know that when you subsidize something you get more of it. Come on now, incentives matter my friend.

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