The Mandate for Contraception- Going Too Far and It Must Be Fixed

One of the things I liked about the Affordable Care Act when it was first introduced was that it tried to put more of an emphasis on prevention in the health care system. We all know our current system has evolved into a “sickness system” trying to fix an illness only after it develops. If we could begin to focus more of our time taking care of ourselves and preventing illness and disease before it happened, the costs would surely decline. It made sense.

And, it also made sense to put a special emphasis on “women’s health” as women tend to suffer disproportionately from chronic disease and for certain conditions adding to the overall cost of health care for everyone.

But there are limits as to how far the law should go.

In 2011, the Institutes of Medicine provided recommendations to the Department of Health and Human

Services of the types of services they believed could improve the health and wellness of women in the population through prevention and ultimately lower the costs over the longer-term. Their recommendations included:

1.       Improved screening for cervical cancer, counseling for sexually transmitted infections, and counseling and screening for HIV

2.       A fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes

3.       Services for pregnant women including screening for gestational diabetes and lactation counseling and equipment to help women who choose to breastfeed do so successfully

4.       At least one well-woman preventive care visit annually for women to receive comprehensive services

5.       Screening and counseling for all women and adolescent girls for interpersonal and domestic violence in a culturally sensitive and supportive manner

In most cases, the recommendations made sense from a strictly economic/cost perspective. But they must be balanced with the rights established by our Constitution.

Only two weeks after the IOM made their recommendations (remarkably fast for any government decision or anything related to the Affordable Care Act) the Department of Health and Human Services accepted all recommendations and required the recommendations to be included in all health plans beginning in 2012 as part of the Affordable Care Act implementation- no exceptions.

Recommendation #2 (related to contraception) moved the discussion away from addressing the cost of health care- to a debate between a woman’s right to choose for some and the right for religious freedom for others. The issue will be settled legally by the United States Supreme Court later this year.

In a Senate debate a few weeks ago, Senator Patty Murray (D-Washington) stated, “What’s at stake in this case before the Supreme Court is whether a CEO’s personal beliefs can trump a woman’s right to access free or low-cost contraception under the Affordable Care Act.”

This is not a right to choose issue- but it remains a health care cost issue ad most certainly a religious freedom issue.

Since the personal beliefs in all of the challenged cases are, in-fact, based on the fundamental religious beliefs of those challenging this requirement, the answer to Senator Murray’s question should be a no-brainer, even to her. If the implementation of this law begins to infringe on the religious freedom and rights of the individuals it has gone too far and it’s time to put it in check.

And we have reached that point- at least for this part of it.