Holy Smoke!

LOL, fili. Steven Col­bert is great. Bet­ter than even Eric Cantor’s unin­ten­tional com­edy, stat­ing: “The pres­i­dent likes to talk about the shin­ing balls of mil­lion­aires, bil­lion­aires and jet own­ers.” — Eric Can­tor, on Fox News.

And while every­one was fret­ting over the man­u­fac­tured debt ceil­ing crisis…

“Start­ing in 2013, the Depart­ment of Health and Human Ser­vices announced Mon­day, insur­ance com­pa­nies will be com­pelled to cover a wide range of women’s health ser­vices, from test­ing for ges­ta­tional dia­betes to coun­sel­ing about domes­tic vio­lence, with­out requir­ing a copay­ment. But it was HHS’ inclu­sion of free con­tra­cep­tion in the slate of ser­vices to be clas­si­fied as pre­ven­tive care that grabbed all the headlines.

The news comes shortly after the Insti­tute of Med­i­cine issued a report rec­om­mend­ing what ser­vices should be offered with­out extra cost to female patients. Even those in the reproductive-​​health com­mu­nity who have long advo­cated for free birth con­trol as common-​​sense pol­icy were sur­prised at the haste with which HHS announced the adop­tion of the IOM’s rec­om­men­da­tions. The idea of free birth con­trol for all falls in the rarely acknowl­edged gray area between bor­ing old med­ical reg­u­la­tions and the promise of unre­strained sex­ual ecstasies—or at least so I’m told by some of the angrier pun­dits on Fox News—and the department’s quick turn­around allowed it to side­step an oppo­si­tion that was just start­ing to heat up its arguments.

Con­ser­v­a­tive oppo­si­tion to this new reg­u­la­tion may have been predictable—right-wing media out­lets rarely miss a chance to rail about the evils of women hav­ing sex­ual inter­course too early—but it still makes no sense. Republican-​​driven polit­i­cal dis­course of late has been about noth­ing but the impor­tance of cut­ting spend­ing and sav­ing money, and so the GOP should be delighted with this sim­ple and clear-​​cut promise of long-​​term sav­ings by mak­ing con­tra­cep­tion free. The IOM report indi­cated that the direct med­ical cost of unin­tended preg­nancy in 2002 was $5 bil­lion, with a sav­ings from con­tra­cep­tion that year esti­mated at $19.3 bil­lion. With nearly half of U.S. preg­nan­cies unin­tended, there’s quite a bit of room to save money with free contraception.

In all prob­a­bil­ity, costs related to unin­tended preg­nancy have only risen since 2002, in part because health-​​care costs over­all are ris­ing, but also because the reces­sion has had a tremen­dous impact on women’s plans for child­bear­ing. In Sep­tem­ber 2009, the Guttmacher Insti­tute reported that as a result of the reces­sion, nearly half of Amer­i­can women sur­veyed indi­cated that they wished to delay preg­nancy or limit the num­ber of chil­dren they would bear. Despite that desire, they were skimp­ing more on con­tra­cep­tion than they had in the past because they didn’t have the money to pay for the well-​​woman vis­its and the birth con­trol. Indeed, after a long decline over the years, the abor­tion rate rose slightly in 2008, an indi­ca­tion that eco­nomic pres­sures could be increas­ing the rate of unin­tended pregnancy.

These new con­tra­cep­tion reg­u­la­tions will pay for them­selves eas­ily in the short term by reduc­ing the insur­ance pay­outs that come along with unin­tended preg­nan­cies, but insur­ance com­pa­nies should expect long-​​term sav­ings. When chil­dren are planned, chil­dren are cheaper.

Of course, insur­ance com­pa­nies have come out against the new reg­u­la­tions, claim­ing they will have to raise pre­mi­ums to cover the costs. This should be viewed as the polit­i­cal exploita­tion that it is, and not a direct response to real costs to insur­ers, as the IOM and HHS were very care­ful to doc­u­ment the moun­tains of evi­dence point­ing to long-​​term sav­ings from these measures. ”

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