Suppose Grant is right, and the Obama administration’s revision to the HHS mandate, whereby religious employers are exempted from having to contribute their own dollars directly to pay for insurance policies that cover contraception, is sufficient to address concerns about religious freedom. It still might be that the policy is practically difficult to implement, as Sarah Kliff explains at the Washington Post:
The administration thinks this is a good deal for insurance companies since the economics tend to work in their favor. Numerous studies have shown that covering contraceptives is revenue-neutral, as such preventive measures can lower the rate of pregnancies down the line. Pregnancy and childbirth coverage is, of course, much more expensive.
“Contraceptives save a lot of money,” a senior administration official argued.
The catch here is that there’s a difference between “revenue neutral” and “free.” By one report’s measure, it costs about $21.40 to add birth control, IUDs and other contraceptives to an insurance plan. Those costs may be offset by a reduction in pregnancies. But unless drug manufacturers decide to start handing out free contraceptives, the money to buy them will have to come from somewhere.
Where will it come from, since neither employers nor employees will be paying for these contraceptives? That leaves the insurers, whose revenues come from the premiums that subscribers pay them. It’s difficult to see how insurance companies would avoid using premiums to cover the costs of contraceptives. They could, perhaps, use premiums from non-religious employers. Those businesses wouldn’t likely object on faith-based grounds, but they probably wouldn’t be keen on footing the bill for people who aren’t on their payrolls.
This sounds like a genuine worry to me. Do we need to start preparing for a new round of private organizations asserting their rights not to be forced to do things they don’t want to do, or does the fact that these organizations aren’t religious ones mean that their consciences don’t count?
P.S. A different worry, now from Kate Pickert at Time:
One aspect of the new policy as yet unaddressed by the Administration is what would happen in the case of a large religious organization that is self-insured – as many Fortune 500 companies are. For an institutions like this, insurance companies like Cigna or UnitedHealthcare are merely claims processing paperwork pushers, with the institution actually holding premium dollars and paying for health services. Would these organizations – via their claims processor – have to reach out to female employees and offer birth control pills?
I honestly have no idea how many, if any, religious organizations fit this characterization, but again it strikes me as a serious concern.
Update: If the Becket Fund is to be believed, the number of religious organizations that self-insure is “hundreds if not thousands”.