Ohio Republicans Continue Their Party’s Obsession With Birth Control
Strange goings on in Ohio.
The Republican controlled legislature in Ohio is currently considering a bill that would ban insurance coverage for abortions for all Ohioans, and bar insurance coverage for one of the most effective methods of birth control for state employees:
Ohio might make it illegal for insurance to cover abortions, even in cases of rape, incest and when pregnancy threatens a mother’s life.
The first hearing for House Bill 351 was held yesterday.
The only exception allowed in the bill, which would affect all insurance policies that cover Ohioans, is in cases of ectopic, or tubal, pregnancies.
The bill also would ban insurance coverage for public employees as well as those on Medicaid for birth control that prevents the implantation of a fertilized egg, such as intrauterine devices, known as IUDs.
During testimony, Rep. John Becker, a suburban Cincinnati Republican who sponsored the bill, acknowledged that the wording can be interpreted to include birth-control pills, which he said wasn’t his intention. An amendment could be introduced to clarify that point, he said.
When it came to IUDs, which are plastic devices implanted into a woman, Becker said they should be included in the ban because they prevent the implantation of a fertilized egg, meaning they can be considered an abortion.
“This is just a personal view. I’m not a medical doctor,” Becker said.
Rep. John Carney, D-Columbus, disagreed, and said that it’s “just a fact” that an IUD doesn’t cause an abortion. He said he found the bill to be “very disrespectful to the women of our state.”
According to Planned Parenthood, which provides women’s health-care services such as access to abortions and contraception, an in-clinic abortion can cost between $300 and $950 in the first trimester.
The bill would eliminate a provision that allows insurance to provide abortion coverage for women in the case of rape and incest, a choice that Carney said should be made by doctors and not bureaucrats.
However, Becker said “the right to life” of the fertilized egg or fetus “trumps those other issues” and that rapists should be executed, not the human products of rape.
There are really two things at issue here, and both of them are quite problematic.
First, of course, there’s the idea of Ohio banning private insurers and their customers from entering into a contract to cover a specific medical procedure. If we were talking only about the insurance plan provided to state employees, which is paid for at least in part with taxpayer dollars, then it seems clear to me that the legislature would be authorized to do something like this, even if it might be a bad policy decision on their part. In this case, though, the state would purport to interfere in the contractual relationship between insurer and insured and state that certain things cannot be covered. At first glance, of course, this would seem to contradict the supposed Republican belief in the free market. After all, if insurers want to offer coverage for abortion and someone wants to purchase that coverage, then what business is it of the state’s? On the legal side, I have to wonder how something like this wouldn’t run afoul of the Constitution’s Contract Clause – set forth at Article I, Section 10, Clause 1 — which forbids states from impairing contractual obligations. At least when it comes to current policyholders, that seems to be exactly what they are doing. But, of course, what do principles and the law matter when it comes to things like this?
Although it doesn’t seem to suffer from the same legal problems as the abortion coverage ban, the effort to ban coverage under state employee policies and Medicaid for contraceptives such as the IUD is similarly nonsensical. Other than surgical options and implanted forms of chemical birth control such as Norplant, the IUD is one of the most effective forms of birth control available. It has been in use for decades and it’s safety and effectiveness have been established. Banning coverage while allowing other forms of birth control to be covered is absolutely absurd and without any basis in medicine or science, as the bills sponsor readily admits. But, then, that’s kind of how the GOP rolls when it comes to birth control issues, isn’t it?
Hovering above all of this, of course, is the question of why exactly the Republicans who control the Ohio Legislature believe that dictating the terms of insurance contracts and making it more difficult for state employees and people on Medcaid to obtain IUDs and other forms of birth control needs to be a legislative priority. Are all of the other problems in Ohio solved? The economy booming? The manufacturing jobs lost in areas around Youngstown, Cleveland, and Dayton restored? Is this really what Ohio voters want the people they elected spending their time on? Something tells me the answer to all three of those questions is a clear, emphatic no. But then, things like principles, science, and priorities, don’t matter when you’re pandering to your party’s base.
This is no sillier than Texas Republicans plan to pray away the gay…
Such therapy is probably covered by Obamacare.
With even 98% of Catholic women using birth control it is amazing. I’m surprised they don’t forbid white women from using birth control but make it mandatory for the “others”.
@Ron Beasley:
Doesn’t Rick Santorum want to do just that?
Because when government has the power to mandate that insurance companies cover certain things, government also has the power to prohibit insurance companies from covering certain things. Thanks Obamacare!
@Ron Beasley: “I’m surprised they don’t forbid white women from using birth control but make it mandatory for the “others”. ”
Not everyone is as racist as you. Deal with it.
Doug, there’s a basic principle of Political Science at work here that I don’t believe you take into account. You may remember the cries of outrage and wave of protests that followed the announcement of Roe v Wade. No? That’s because it didn’t happen. Catholics had some pain, but most protestant theology held that life began at birth and they were comfortable with abortion and birth control. Then holy roller preachers and conservative politicians discovered they could raise a lot of money by making an issue of it. After forty years of screaming that every life is sacred and life begins at conception, Rep. Becker (who’s from about fifteen miles north of this keyboard) I’m sure believes this is the most important thing he can do.
Never forget, gVOR’s law of PolySci – CONSERVATIVES BELIEVE THEIR OWN BULLSHIT.
Also, read Lakoff. For conservatives, freedom means being able to do their duty as they see it. And it is their duty to force you to do your duty…as they see it.
Hey GOP keep on with that reaching out to women stuff – you’re doing great!
@Gavrilo:
You mean like when the Government mandates that insurance companies cover glass replacement on my truck?
Gawd, aren’t you embarrassed by having to make these stupid arguments?
Haven’t you noticed that the GOP has given up and accepted that Obamacare is working?
Somebody needs to retake high school biology. It seems to be a thing for Republicans to propose legislation on science issues, then try to defend their views by saying, “I’m not a scientist.”
Deny global warming and filibuster anti-global warming legislation? Defend it by saying, “I’m not a scientist” when asked about global warming.
Ban contraception and abortion? Say , “I’m not a scientist” when asked why they are banning contraception.
The Republicans in Ohio are hitting the trifecta with this bill:
Anti-sex
Anti-science
Anti-women
Fortunately, the good people of Ohio can solve this problem in elections later on this year. Let’s hope they do.
@beth:
http://www.salon.com/2014/06/06/republicans_think_touching_glamour_makes_them_female_friendly/
@C. Clavin: They just don’t have a clue do they? I almost feel sorry for them. Don’t they have wives, daughters or sisters?
@alanstorm:
So, fill me in, how is Ron’s statement racist?
Is it because he referred to “white women?”
Please proceed, Republicans.
Good stuff at the wiki link, also.
I don’t believe that government should be able to force insurance to cover birth control (although I think it should cover it). I also don’t believe it should be able to force insurance *not* to cover birth control. Either you believe in private contract freedom or you don’t, Republicans.
Every so often we are reminded that elections have consequences. More reason to reject the notion that both parties are the same, that it doesn’t matter which party has majority power in the legislature and in statehouses.
@Hal_10000: Should government be able to “force” insurance companies to pay for antibiotics? Vaccines? Heart surgery? Would you really want a system where insurance companies can offer a myriad of plans offering coverage for some things but not others and the only way you can compare them is to wade through pages and pages of fine print on different policies? And when people take the chance not to be covered for certain ailments, who pays for them when they wind up in the emergency room or need long, expensive medical treatment? Or are you one of those “just let them die” libertarians?
The party of small government.
@Rafer Janders: and when pregnancy threatens a mother’s life.
The pro-life party too.
They really don’t want to move back into that big White House in a few years do they. Jeez. Chill out, drink a beer, get laid, get a life and stop worrying about others’ private lives
Isn’t it Jenos Idanian and some other commenters who are always going on about how Republicans believe in empowering the individual to make their own decisions, rather than letting the government make it for them?
Except, that is, when those individuals are women, it seems….
@ Rafer Janders
Pretty sure there are also exemptions for black, brown, muslims…
If you know a woman who votes GOP, ask her “Why?”
@Rafer Janders:
On the subject of Mutt Williams (a.k.a. Jenos), this is what he argued in a previous thread:
This is clearly one of these “reasonable compromises”!
Remember this story next time you hear some Party of Stupid representative say “We just need to do a better job of explaining to women (or etc) how our policies are better for them”
@beth:
I don’t think you can compare things like antibiotics to birth control, which is an elective medication and a *planned* expense. I am incredibly dubious that any employer would bother with picking and choosing coverage to force people to wade through “pages” of forms. But, in principle, yes. One of the biggest reasons I work for the employer I do is because of the insurance (which already has coverage exemptions for things they don’t want to pay for). Let’s keep in mind that such a system already exists and is going to be pushed onto us even further. This is the *entire idea* behind managed care and behind the boards that Obamacare has set up to review procedures. What the birth control mandate says, in effect, is that every medical procedure and medication under the sun is subject to review … except birth control.
And while I appreciate your love of straw men, “let them die” libertarians doesn’t describe libertarians except in the imaginations of certain people. Libertarianism ≠ whatever it is you don’t like.
“And while I appreciate your love of straw men, “let them die” libertarians doesn’t describe libertarians except in the imaginations of certain people.”
Actually, it does. Many think government should have no involvement in the provision of health care. They assume that there will then be enough charity care and “a miracle will occur” resulting in lower health care prices. In other words, they dont read history.
Steve
@Hal_10000: Elective? Tell that to the thousands of women who take birth control for health reasons that have nothing to do with pregnancy. You do know women have these things called periods every month and all sorts of bad symptoms can be regulated through birth control. Now maybe you think it’s elective not to want to pass out from heavy blood loss or be doubled over with cramps or migraines to the point where you can’t do anything, but I think most women suffering from these very real physical medical problems wouldn’t see anything elective about wanting a cure. And tell it to the women whose doctors have told them they shouldn’t get pregnant or they can be risking their lives due to other conditions they may have. And even if you don’t have any of these medical problems, birth control is nothing more than on a par with vaccines – it prevents you from getting the medical condition called pregnancy.
I believe you are completely wrong about the review procedures built into the ACA if you think birth control won’t be reviewed and adjusted as new forms are invented and come on the market and studies of the efficiency of different forms are completed and revised but I also believe you want to dislike the President and this program so much you won’t allow yourself to listen to logic about it.
@beth:
And let’s not forget the ovarian cysts and endometriosis (which can cause infertility if untreated), and being so addled by insomnia due to your out-of-whack hormones that you can’t think straight.
@al-Ameda: Especially since I am a blond haired blue eyed Swede.
Not to belabor a minor point in the discussion (one word, in fact), but I’m not denying those aspects of birth control — I argued that very same case to conservatives when the Sandra Fluke business was going on. And it’s one of the reasons I would oppose efforts to forbid insurance companies from providing BCP coverage. But “elective” means anything that is not urgent or life-saving. The pills that control my migraines (mostly) are elective. Most medication we take is elective. Antibiotics are not. You simply can’t, as you did, put birth control in the same category as antibiotics or heart surgery, which are routinely critical and/or life-saving. I believe in keeping coverage mandates to a minimum because I don’t think outlawing low-priced insurance makes people’s lives better.
@Hal_10000:
Well sure. If one considers “living” to be elective. Personally Hal, I smell BS on that statement. Your basic argument is rational and at the very least food for thought, but none of the medications I take are elective. Without them I would probably be dead within 6 months.
@Hal_10000:
Epic Crabwalk Fail there Hal.
Seriously. You have to learn when to put the shovel down.
@Hal_10000:
Sure, as long as you consider good health and delaying death to be elective.
Take my father-in-law’s blood pressure medication, for example — not taking it isn’t going to kill him. Not today, that is, and not tomorrow. Sure, sure, within a few more years not taking those BP meds will cause him to suffer a stroke or heart attack , but the important thing is, it won’t kill him today. So it’s “elective”….
Which is like birth control. Most users would be dead without it in six months.
I understand the point about necessary medication. My wife take medication for an auto-immune condition that would disable here in a while. But you simply can’t compare life-saving medications to birth control. You can’t compare life-saving medical procedures to IUD insertion (which every insurance company defines as elective; I’ve read the informed consents myself). Someone who doesn’t get heart surgery will be dead soon and has no alternatives. Someone who has a raging infection and doesn’t get antibiotics will be dead soon and has no alternatives. Blood pressure medications, which one my relatives takes, is sometimes the only means to keep blood pressure under control.
Let me turn this around. If the GOP proposed a “compromise” where birth control would be covered in case of medical necessity (e.g., pregnancy would be extremely risk) but not for personal use, would you accept that? Or do you define all use as medically necessary?
@Hal_10000:
Right, but someone who doesn’t take blood pressure medication won’t be dead “soon.” They’ll die long before their time, but they may only die within a year, five years, ten years of not taking the medication. You’re making a somewhat arbitrary distinction between medicines which are immediately necessary or not.
@Hal_10000:
What’s the “personal use” of birth control pills? They’re not like Scotch or red wine which people take to get a nice buzz one or for a fun time Saturday night. They’re medicine taken to prevent the medical condition of pregnancy. If you want to prevent the medical condition of pregnancy, birth control pills are one of the medically necessary ways to do it.
@Rafer Janders: Birth control pills aren’t necessary for him, so they’re nothing he should have to pay for. Am I right?
@Hal_10000:
You are aware, aren’t you, that pregnancy by itself is medically risky? Not just “high-risk”pregnancies but all pregnancies? Here, let me educate you some:
Despite impressive gains in safety in recent decades, pregnancy remains risky business. From early in pregnancy until some weeks after its conclusion, pregnant women are at increased risk of morbidity and mortality compared with women who are not pregnant. This review summarizes recent national data from the U.S. Centers for Disease Control and Prevention, including vital statistics from the National Center for Health Statistics. Ectopic pregnancy is substantially more dangerous (38 deaths/100,000 events) than either childbirth (nine) or legal abortion (less than one). The three leading causes of maternal death today are pregnancy-induced hypertension, hemorrhage, and pulmonary embolism. Although comprehensive data on pregnancy-related morbidity are lacking, about 22% of all pregnant women are hospitalized before delivery because of complications. Women of minority races have much higher risks of death than do white women, and the same holds true for older women and those with limited education. For most women, fertility regulation by contraception, sterilization, or legal abortion is substantially safer than childbirth.
http://www.ncbi.nlm.nih.gov/pubmed/8178896
But we have to make some distinction in which medications have mandatory coverage and which don’t. Indeed, the entire system is set up to make those distinctions based on medical necessity and expense. The drugs that treat my wife’s condition may soon not be covered in some countries because they are so expensive.
What I prefer is that the government stay out of those decisions as much as practicable for a variety of reasons. Not wishing to outlaw low-priced insurance is one. Freedom to contract with another. A big one is govt’s poor track record (e.g., the Avastin/Lucentis thing). My preference for keeping coverage mandates to a minimum indicates that birth control lies on the other side of it, except when medically necessary (e.g., after surgery).
@rachel:
“Personal use” of birth control pills – I’ve never heard of anything so idiotic. It’s not like popping a Valium, man.
But not the only choice. Above, BCP coverage mandates were justified for “health reasons that have nothing to do with pregnancy”.
My insurance covers it. And I’m glad it does. I think insurance should cover it. Again, I’m not opposing insurance coverage of birth control. I’m opposing mandating it.
@Hal_10000:
Well then thank God you’re not in charge of deciding what’s medically necessary or not because it seems like according to you if you don’t need it, it’s not necessary. I prefer to take my cue from real live medical doctors who consider birth control pills a necessary and important part of women’s health care.
@Hal_10000:
Oh, yes, let’s have profit-driven companies take care of these things; it’s so much better for citizens to have their health issues decided by a corporation’s bottom line than by the government they elected to serve them!
@Hal_10000:
Do you somehow not consider pregnancy to be a medical condition? If yo want to avoid the medical condition of pregnancy, birth control pills are medically necessary. (And yes, there are also other methods — but BCP is one of the safest, cheapest and most effective ways to do it).
Yes, they can be used to treat other medical conditions as well. And your point is….?
@beth:
I think part of Hal’s problem here is that he’s psychologically unable to see pregnancy as a medical matter, instead considering it something that just naturally happens to women and isn’t really part of the medical / healthcare realm.
@Hal_10000:
Based on medical necessity and expense, birth control pills are far, far cheaper than the cost of a full-term nine month pregnancy.
@Rafer Janders:
You’re wrong. I worked in the medical field for 13 years. We had a patient die from pregnancy complications. I’ve had friends, relatives and a spouse go through pregnancy complications. I worried every time my wife or anyone else I knew got pregnant (and on occasion my worries were justified).
Your problem is that you want to shoehorn everyone into the ignorant Republican box and that you can not see the difference between thinking something something is a good idea and thinking it should be required by force of law.
@beth: “Don’t they have wives, daughters or sisters?”
They do. They are called “possessions.” Hence, they are treated as property.
@Rafer Janders: “You’re making a somewhat arbitrary distinction between medicines which are immediately necessary or not..”
Perhaps Hal_10000 is a physician making his diagnosis in the Bill Frist/Terry Shaivo tradition.
@Hal_10000: So you know for a fact that BC can prevent premature death or injury, but you think it’s just elective like other treatments that don’t prevent death or injury, like your migraine medicine? Is that right?
Somehow, this is not making you (or your case) look good.
@Hal_10000:
Now you’re not making any sense. You went from claiming that birth control is a “personal choice” and not medically necessary to conceding that it can prevent death, injury and multiple other medical complications.
Not every good idea needs to be a law. But our history with medical insurance and healthcare — and with the car industry, Big Oil, Big Coal, etc. etc. — shows us quite clearly that, unless required to by force of law, private business will not cover a good idea if it means they can save a buck.
@Hal_10000:
Let me turn this around. Imagine that there was a medical condition — let’s call it “Nonexistia” — that men could catch from having sex.
Nonexistia, once acquired, puts men at increased risk of death, disability and other complications compared with those who don’t have it. Nonexistia lasts for nine months, during which time the men become increasingly debilitated, suffering daily nausea, vomiting, mood and blood pressure swings, extreme weight gain and loss of mobility, eventually becoming so disabled that most of them can no longer work. About 22% of men with Nonexistia will wind up in the hospital for complications at some point during those nine months, and all of them, 100%, will eventually have to be rushed to the hospital at the end of that time, where they will spend hours and in some cases days in wrenching agony while they anally pass a large bowling ball size tumor. A few men don’t survive this, dying in the attempt. Even after the nine months pass, the bodies of men who had Nonexistia will never be quite the same.
Now let’s imagine there was a pill that could prevent men from catching Nonexistia. Do you seriously believe that coverage of Nonexistia would not be mandated as a medical necessity for all insurance plans? Hell, it would practically be considered a sacred right of citizenship.
Let’s take that a step further…if men could get pregnant from sex, there would be no medical intervention involved with birth control…it would be as easy to get as candy and soda at the corner store…
Also there’s the little fact that the more birth control pills you take, the more you’re protected against ovarian cancer…..
HAL, your argument is exactly why emergency rooms don’t give out cancer medication. Because their patients aren’t dying “immediately”. Sure, you won’t die that day. And you won’t die the next day. And you won’t die the day after that. But if you don’t treat the cancer, at some point it will have progressed to the point of being terminal and then yes, you WILL die.
Libertarians are so cute.
@Rafer Janders:
Now let’s imagine there was a pill that could prevent men from catching Nonexistia.
Is it derived from unobtanium?
Couldn’t resist.
As always we need to get to the point of all the Republican schemes to
limitban birth control and abortion.They don’t want women to have sex…Unless they are Las Vegas hookers aka etc.
http://www.motherjones.com/mojo/2014/04/gop-las-vegas-convention-religious
@Rafer Janders:
Ok, I think this is missing a key point of Hal’s argument. He wrote this:
The question is whether or not the pregnancies that led to those complications were intended or not.
Pregnancy is an outlier to the degree that its a medical condition that many people *want to get.* This differentiates it from say an STD.
Keeping that in mind, birth control never enters the equation when someone wants to get pregnant and said pregnancy results in life threatening complications.
All that said, certain forms of birth control have important — if not critical — off label uses. And if a plan covers non-critical, but still very important, day-to-day drugs, there is no question it should cover those forms of birth control.
And I believe that any plan that covers male ED medication should also, by law, cover birth control.
@Matt Bernius:
No, not really. Because we’re discussing women who want to take birth control pills, and so it’s a fair assumption that women taking birth control pills don’t intend to become pregnant.
@Rafer Janders:
Ok, get your point now. I think, in internet discussions, it’s always good to make one’s positions as explicit as possible. I agree with your thinking — its just on a quick scan, I feel that a couple of steps to understanding your point were left out.
If I am reading you right:
To the degree that *any pregnancy* can lead to significant, up to and including, life threatening complications, birth control is a critical means of preventing such life-threatening possibilities for those who don’t want to be pregnant in the first place.
I know from your side that probably seems obvious from the get go. But it’s worth explicitly expressing it — especially since it’s a different argument than Beth was making.
What’s interesting — and possible very useful — about this line of thinking is that it reverses the last 100 years of medical work that were intended to redefine pregnancy as a safe and controllable condition. Anyone who has studied the history of childbirth knows that prior to the twentieth century, pregnancy was considered anything but safe.
@Matt Bernius: Note that unless you have all that medical attention, then YES, pregnancy IS a dangerous condition for women.
@grumpy realist:
Actually, I’d take it just a step farther — namely that even with all that medical treatment, pregnancy *can still be* a dangerous condition.
Which is what @Hal was indicating @here. Modern medical practices have made it *safer*.
For debates sake, it is fair to ask how,relatively speaking, unsafe pregnancy actually is:
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2223rank.html