Grant Gallicho February 25, 2012 - 11:14am
What's happening at Catholic News Service? A few weeks ago, I took note of a CNSarticle that looked like a news story but smelled like an opinion piece. On Wednesday CNS published a piece that purports to bust myths about the contraception-coverage mandate but reads more like a USCCB press release.Look at the lead:
Exaggerations and outright misrepresentations about the Department of Health and Human Services' contraceptive mandate have been appearing in White House "fact sheets" and mainstream media. Here are some of the more frequently cited claims and the facts to counter them.
The piece does not pin myth to mythmaker. Did the White House claim that self-funded health plans are "seldom used"? Or was that someone in the big bad MSM? Hard to say.Who floated the theory that because twenty-eight states already have contraception mandates the situation in those states won't change after the mandate takes effect? The article doesn't say.To be sure, the piece does correct a couple of common confusions: The claim that 98 percent of Catholic women use or have used contraception is inaccurate; astudy [.pdf]showed that 98 percent of self-identified Catholic women had used contraception (edit: other than natural family planning) at some point during childbearing years. And it's important to keep in mind that even though twenty-eight states require insurance companies to include contraception in their prescription-drug coverage, organizations that self-fund their health plans could avoid providing contraception coverage because such plans are federally regulated. That won't be an option under the HHS ruling.But some of the article's "facts" dodge important questions. Take, for example, its facts about self-funded employee health plans.
A majority of Americans who have private health insurance are in self-insured plans, according to separate reports by the Congressional Research Service and the Kaiser Family Foundation and Health Research & Educational Trust. The percentage was 44 percent in 1999, 55 percent in 2008 and had increased to 60 percent by 2011.Employees in large companies (those with 200 or more employees) were even more likely to be covered by a self-insured plan. Eighty-two percent of workers at large firms -- and 96 percent of those who work for a company with 5,000 or more workers -- were in a self-insured health plan.There is no precise count of how many of the employees working for Catholic organizations or institutions are in self-insured plans, but the number is believed to mirror that of the general population.
Hang on. The relevant question is: how will the HHS ruling affect religious employers' self-funded health plans? It's good to know how common such plans are across the full range of employers. But this is a Catholic News Service report. If it's true that no one knows how many employees of Catholic organizations are in self-funded plans, then find out. Work your beat: What does it take to self-fund an employee health plan? (A lot of cash.) How have affected Catholic institutions dealt with the question? (At least one bishop found self-insurance too expensive, so he provides contraception coverage to diocesan employees.) "Is believed" is not good enough, not if what's really at stake is the freedom of Catholic institutions to practice their religion.The CNS article presents other "facts" in a misleading way. For example:
Myth: Adding contraceptive coverage to health plans will be net cost-neutral, because those covered by the mandate will have fewer unintended pregnancies.Fact: Pharmacy directors disagree. An online survey by New Jersey-based Reimbursement Intelligence of 15 pharmacy directors representing more than 100 million employees or their dependents found that nearly 50 percent thought the mandate would increase costs, 20 percent thought it would be cost-neutral and none predicted that it would save money. More than 30 percent said they didn't know what the effect would be.Several respondents also raised the question of whether the mandate to provide contraceptives free of charge would require them to give away brand-name medications, even when generics are available.
It certainly is not a myth that adding contraception coverage to health plans will be net cost-neutral. [Here I'm cribbing from a comment I left on another post.] HHS studied the question, and found no evidence that contraception coverage increases insurers' costs. In 1999, for example, Congress required Federal Employees Health Benefits plans to cover FDA-approved contraception. At the time, the premium pricing had already been determined. So the office that administers the federal health benefits program created a reconciliation process for insurers who found the contraception mandate financially problematic. Yet, as the HHS study points out: There was no need to adjust premium levels because there was no cost increase as a result of providing coverage of contraceptive services. That program is the largest employee health plan in the United States.Actuarial studies also support that finding. From the HHS report: "When medical costs associated with unintended pregnancies are taken into account, including costs of prenatal care, pregnancy complications, and deliveries, the net effect on premiums is close to zero. One study author concluded, The message is simple: regardless of payment mechanism or contraceptive method, contraception saves money.There are also indirect costs to consider, such as time away from work. Global Health Outcomes developed a model that incorporates costs of contraception, costs of unintended pregnancy, and indirect costs. They find that it saves employers $97 per year per employee to offer a comprehensive contraceptive benefit.Finally, PriceWaterhouseCoopers actuaries concluded that contraceptive coverage is ultimately cost-saving.Does Catholic News Service expect readers to believe that an online survey [.pdf] of fifteen pharmacy directors undermines the conclusions of those studies, or conclusions drawn from the experience of the nation's largest employee health plan? Especially when 20 percent of them (in layman's terms, three people) say contraception coverage adds no cost to insurers, and 30 percent (four or five people) don't know? That means about half the surveyed pharmacy directors are not convinced that adding contraception coverage will increase costs to insurance companies. How does that comport with the first sentence of this "fact"?Mythbusting is a popular online sport. In theory, there's nothing wrong with CNS reporting stories that correct common misconceptions. But how it goes about doing so says something about its integrity as a news organization. This attempt is journalistically strange. It contains no quotes. It has one point of view. It conveniently ignores important aspects of the record it supposedly wants to correct.So I return to the question I led with: What is happening at CNS? For decades, Catholic News Service has served the church and the wider culture by providing reliable, professional reporting on Catholic news. Its excellent reputation derives not only from its admirable work, but also from its independence. The CNSmission statement is clear: "While created in 1920 by the bishops of the United States, CNS is editorially independent and a financially self-sustaining division of the U.S. Conference of Catholic Bishops."Has that changed? Are bishops putting pressure on the organization to report stories that serve USCCB policy priorities? If it is the case that CNS is no longer editorially independent of the USCCB, then the organization must disclose that to its readers. Failure to share that information, if true, would constitute a serious violation of journalistic ethics.