The Affordable Care Act, or Obamacare, is coming under fire again tomorrow. This time the nice folks from Hobby Lobby craft stores and Conestoga Wood Specialities are contesting the portion of the law that mandates insurance coverage, without copay, of preventative medical services. Translated, that means insurance policies must pay for a certain list of medications and procedures that were deemed “preventative care” by the Institute of Medicine, an independent review board. This list includes non-controversial things such as diabetes screenings and mammograms. It also includes contraception, which is the issue Hobby Lobby and its brethren oppose.
The plaintiffs in this case say that four particular types of covered contraception (two IUDs and two emergency contraception medications) actually induce abortion and their religious principles demand that they not pay for coverage of such things for their employees. Never mind that the devices and medications in question do not end pregnancies. There is a line in the fine print that says that they might and that’s enough of a risk for the Hobby Lobby folks to want to stay away.
I’m pretty sure they’re going to win. And I’m pretty angry because their adherence to a strict anti-choice dogma is potentially going to undermine the most sweeping reform of health care financing this nation has seen since Medicare.
Contrary to popular belief, the Affordable Care Act was not an act of naked tyranny perpetuated by the Obama administration just for the fun of seeing Glenn Beck turn purple. The prime directives of the law are two-part. First, establish a minimum threshold for what constitutes adequate health insurance (prior to the law there was no uniform definition of what constituted health insurance at all, much less what insurance must cover to be acceptable). Second, reform the market for purchasing insurance such that vendors can no longer shut out customers. These reforms are critical because it means everyone can now buy insurance and the insurance they buy will actually cover the services they will need. This was not true before this and you don’t have to go far into Google search results to read horror stories of insurance leaving sick people out in the cold.
So. The Affordable Care Act affects everyone in America and, I contend, will affect them in a positive way. Deconstructing this law, I contend, harms everyone in America.
But. Then there’s Hobby Lobby. The family who owns it is devoutly Christian and wants to make sure they don’t spend a single penny on health services that might be construed as abortion. And if you listen to the commentary, that’s a sure-fire outcome of paying for IUDs and emergency contraception.
Or is it? Let’s crunch some numbers. According to Forbes, in 2013, Hobby Lobby employed 23,000 people. For the sake of argument, let’s assume the universe of employees is statistically the same as the rest of the US, as outlined in the 2010 census. So 50.8% of the 23,000 are women, leaving us with 11,684 employees. Of those 11,684, 36% are between the ages of 18-44, prime child bearing years, so that bring us down to 4,206 people likely to be using Hobby Lobby insurance to pay for contraceptives. According to Guttmacher Institute, 5.6% of contraceptive users choose IUDs so that would be 235 Hobby Lobby employees. IUDs have an effectiveness rate of 99.9% because IUDs prevent ovulation and/or prevent sperm from making it to the egg for the most part. If they fail to prevent either of those events, a sperm could fertilize and egg and not implant due to the IUD. If that happens 1 out of a 100 times, that’s 2 Hobby Lobby employees.
Two. The owners of Hobby Lobby are willing to undermine a health insurance law that has a positive benefit on EVERY SINGLE PERSON IN AMERICA for the sake of two fertilized eggs. And I’m pretty sure the Supreme Court is going to allow it to happen because of a misbegotten notion of religious liberty.
This is the moment when religion overrides science and technology and medical best practices. This is when religion overrides the greater good to assuage the conscience of a minority. This is the arrogance of faith.