Friday, February 10, 2012

A difference in contraception provision without much of distinction

The White House, feeling the heat from Catholics' and conservatives' hysterical reactions to its original decision to treat religiously-affiliated non-profits like other employers by requiring them to include contraceptive care in their health insurance plans, announced a new policy today--or did it?
Women still will be guaranteed coverage for contraceptive services without any out-of-pocket cost, but will have to seek the coverage directly from their insurance companies if their employers object to birth control on religious grounds.

Religiously-affiliated non-profit employers such as schools, charities, universities, and hospitals will be able to provide their workers with plans that exclude such coverage. However, the insurance companies that provide the plans will have to offer those workers the opportunity to obtain additional contraceptive coverage directly, at no additional charge.

Families would have access to the same insurance coverage at the same cost as the original proposal. The only difference is that the coverage would not formally be part of the plan, and families would have to apply for coverage separately and directly with the insurer.

Pick your metaphor--fig leaf, shell game, smoke and mirrors--there isn't much of a change (though given the Catholic church's fondness for ritual and given the clergy's history of studied blindness and Catholics' general cognitive dissonance regarding contraception since Humanae Vitae in 1968, you could see how President Obama would think he could get this one past them).

Which isn't to say that the policy is costless.

The policy increases the paperwork burden for families and insurance companies. Although the coverage is "free" to families, these minor hassles along with people's inertia will undoubtedly reduce take-up. So in the end, fewer families will get coverage, and administrative costs will rise.

The usual practice of this blog is to argue on the basis of rationality. However, in this case, President Obama has proposed something so outrageously and audaciously irrational that it just might work.