Obama's Catholic hospital decision

[anvi]

I doubt they would have announced this deal without clearing it with the insurers first.  In addition to the low costs of providing this additional coverage, I'd tend to think the insurers would prefer to flip for the few pills that the few woman from these institutions might ask for than pay for maternity costs and all that comes after.

[anvi]

Not for nothing, but more than a decade ago, the EEOC ruled that companies which offered health care plans to more than fifteen employees that provided prescription drugs but did not cover birth control medication stood in violation of title VII of the 1964 Civil Rights Act.  That ruling has been upheld by federal courts, in Erickson v. Bartell (2001) and several other cases.  All the initial Obama Administration decision did was to extend the same principle to companies with less than fifteen employees.  You can discriminate on religious grounds, but not on the basis of sex, which is what you are doing when it comes to drawing a line at medications related to pregnancy.  And that's been the practice long before PPACA and long before people were trying to kick up wedge bs for the 2012 election year.  Now you guys want to tell me that this is all about the insurance mandate, the sudden and immanent overthrow of the republic, and once again, the forced bankruptcy of insurance companies.  Yeah, ok.  I'm only sorry that the Obama people caved at all.

Oh well, 'tis the season for making mountains, so, by all means, carry on.

[anvi]

As an aside, paying for birth control medications is not really health insurance at all, unless you think paying for toothpaste is a matter for health insurance to cover. It is a predictable expense. Insurance should be for unpredictable expenses, and if one cannot pay for predictable expenses, that is why we have an income tax credit, medicaid, and so forth. The concept of insurance, and just paying for the necessities of life for the impecunious as part of the social safety net, are being conflated here.

As far as I understand it, the rule under discussion here applies to prescriptive contraceptives, not to over-the-counter meds, so I'm not sure how the toothpaste analogy fits.  As has been mentioned above, certain medications that can also be used as contraceptives are also sometimes prescribed for other health-related purposes.  But even if we are talking about prescription medications being used for purposes of avoiding pregnancy, it seems to me that this is the very point of the EEOC and he courts finding CRA Title VII relevant.  Pregnancy is not an entirely predictable outcome of sexual activity (sometimes it happens, sometimes it doesn't and for a host of reasons), and if a woman in consultation with her physician decides certain prescriptive contraceptives are appropriate for her condition or her life plans, the employers' exlusion of them from the coverage they offer is a form of sexual discrimination (men don't get pregnant, last I checked).  I think one reason that many people are not aware of this legal history is that the courts that have decided such cases have not uniformly enforced it--but the results of the 2001 case have led to something like over 90% of plans, even at religiously affilliated institutions, covering prescription contraceptives already.  

Of course the bishops are unhappy; the bishops are unhappy that the U.S. and every other place on the planet does not follow the Vatican's moral directives.  But, as far as I'm concerned, I say: "no, this republic is not a religious state, Catholic bishops don't get to control what women do with their bodies in this society, whether those women happen to be Catholic or not, and if I have to protect their rights and their medical needs with federal law, I'm going to do it, and the bishops can bite me."  They can believe whatever they want, but they don't get to do whatever they want, especially when it comes to women being able to get medicines that their physicians have judged it appropriate for them to have.

[anvi]

Yeah, neither Obama nor anyone in the White House made much of an attempt to defend themselves on the legal grounds.  I'd say that there are two main reasons for this.  The first one everyone has noticed; the president is, at times, a wuss, and I doubt, given the fact that it's an election year, this will be the last time this quality will manifest itself when faced with a wedge issue.  The second is that this White House seems unwilling, in the heat of a political fight, to make what would otherwise be a clear legal case for themselves.  They had a pretty solid legal basis for participation in the U.N. action in Libya, and they allowed themselves to get beat up over it for nothing.  Now there's this too.  It's very strange to me, because the president is a constitutional lawyer, and while I've no doubt at all there are better ones, I'm just as sure that he isn't the dumbest one on the block, so why he doesn't lean on that background when he needs to, and when it would otherwise serve him well, is silly.

[anvi]

I hear you, Ernest, and it's perhaps true that, as a general rule, that politicians don't sound good giving legal defenses of policies, especially when they're controversial.  But something simple, that articulated the grounds for the legal principle, might not be too hard a sell.  When challenged on the supposed unconstitutionality of U.S participation in the Libya operation absent consent from Congress, for instance, why not just say: "We are under a congressionally mandated treaty obligation with the United Nations, and the Constitution recognizes treaty obligations as the supreme law of the land."  Or, with this issue, why not just say: "failing to cover prescription contraceptive medication for women has been found by federal courts to violate a woman's civil rights, and the Affordable Care Act passed by Congress directs me to implement these provisions, and it's my job as president to faithfully execute the laws."  That way, you articulate a principle that you're following; the bishops' problem lies with the courts, not with the president, so it deflects the controversy and allows Obama to stand strong for the constituency of women.  Maybe he has to give other political justifications too, of course, but I don't see why saying these things would hurt his case.  The way he handled it just features him piecing together an incoherent solution, one that won't satisfy any of his critics, and placates only a few Senate Dems like Kerry and Casey (Senate Dems never waste an opportunity to muscle Obama around, and the more he lets them, the more they do it).  Why not stand for something, and find a way to look good doing it?  But, I realize all this is armchair quarterbacking on my part; I, after all, never got elected to any public office, and there are lots of good reasons that is true.