Insuring contraception is preventive care

The weighty cost of health care is driving equally weighty political debates, both in Maine as state government struggles with a budget shortfall in the Department of Health and Human Services, and nationally as the Affordable Care Act emerges as a key issue in this year’s presidential campaigns.

Although the cost of health insurance has gotten top billing, since it has hamstrung businesses from investing in other activities which could create jobs, at the heart of the discussion is the cost of care. Programs that encourage avoiding unhealthy activities — smoking, eating fatty foods — and encourage healthy activities — regular exercise, preventive medicine — have the potential to lower costs.

Preventive care, most everyone agrees, is a low-cost, high-yield approach. One of the highest yielding preventive steps health care management can take is to reduce unwanted pregnancies. A woman whose own health is poor, or whose age might cause a risky pregnancy, or whose family, relationship or economic circumstances threaten to adversely affect the pregnancy may require substantial health services.

And then there are the babies born to mothers and families not prepared for them. Their first five years of life may require medical and other services provided on the government’s dime.

All of which makes the objection to requiring health insurance companies to cover the cost of contraception perplexing. The Affordable Care Act requires all insurance plans to provide contraception at no cost to members. That provision of the law goes into effect in the latter half of this year. Insurance plans for religion-affiliated institutions — hospitals, nursing homes, schools, but not places of worship — will have to also provide contraception beginning late next year.

The law gave such religious institutions an extra year to comply.

Opposing the provision are Catholic church officials, including Bishop Richard Malone of the Roman Catholic Diocese of Maine. In a letter to church members, the bishop wrote: “With the stroke of a pen, the [Obama] administration has violated our right to act in keeping with our conscience. As a community of faith, we must act on this matter courageously, decisively and promptly.”

Mark Mutty, public affairs director for the diocese, argued that the church, which operates or funds schools, day care centers and health care facilities, “would have to violate its tenets to pay for and provide that service.”

Some Catholics, the bishop must realize, use contraception, despite the church’s prohibition on it. And insurance plans cover all sorts of services that one may or may not endorse.

Some plans cover therapies with which some people disagree on principle or are merely skeptical about their efficacy. Just because they are covered by a plan to which one’s employer subscribes which includes some objectionable coverage should not lead to elimination of that coverage for all. The law is not requiring that anyone use contraceptives, just that they be available.

President Barack Obama’s signature legislation aimed to lower health insurance costs and the cost of care. It will be a major issue in the contest between the president and the Republican presidential nominee. We can argue about how well the law will achieve its aims. But there is little reason to dispute that making safe and widely used contraception available to more people is good, preventive medicine that saves lives and saves money.