Follow up to “free birth control” announcement: freedom

I recently posted that a new regulation from the Obama administration requires insurers to cover birth control for free. This was definitely the spirit of the guideline. It suggests, as I said in the post, that the administration sees the ability to plan your family or lack thereof as a right rather than a privilege.

That said, I’m seeing a lot of angry comments around the web, which point out the financial reality that nothing is free. This is true. As I’ve said from the beginning, the universal health care bill is dangerously flawed. It forces insurers to do lots of good stuff, but does not regulate premiums at all. Expect those to skyrocket in response to all the new expenses the bill forces on insurers. If they don’t skyrocket, it’ll be because of the super draconian measure of the bill that its fans tend to ignore: it forces people who don’t have insurance to buy some as of 2014.

“Oh,” people tell me, “they’ll make it cheap for lower income people.”

Yeah. Don’t bet on it. The government has always used magic books in which the cost of living is much lower than folks living in reality find it and dollars stretch for miles and miles. There will be a big gap between the people who get assistance and the people whose unavoidable, unmitigatable expenses really don’t leave them room to pay for an insurance policy.

But that’s not a problem specific to this new women’s preventive care regulation. That’s a problem with the whole bill, and it should be discussed in the context of that bill’s flaws and what we’re going to do about them.

I am also seeing rumors that women who get brand name pills may still have a co-pay if there’s a generic available, but I can’t find a source for this. It wouldn’t shock me.

So while this may reduce your monthly bills by a co-pay, it may raise the amount your employer deducts as your share of your insurance premium. Or it may reduce your next raise, because the employer can only afford to pay $X for you, and the premium has made another little dent into that amount. It should also be noted, however, that everyone who has insurance will be paying a tiny bit of your copay under this new regulation. The burden for all insurance-provided birth control will fall on consumers, but on all insurance consumers instead of just the women who are using birth control right this minute. That may actually reduce your expenses compared to what they would have been had the bill not included this regulation, or even had the bill never existed (I think skyrocketing premiums were probably going to happen no matter what over the next few years, but we’ll never know).

The regulation seeks to create a perception of freedom, however, and that’s important. If nothing is free, and it’s not, then this whole idea of “freedom” that the US clutches so tightly with its pearls is a bunch of crap, right? No, it’s a perception. No one has absolute freedom – various social and survival forces are pushing on every single one of us all the time, and that’s just life. Freedom is simply the lack of special oppression directed at particular groups of people.

This regulation creates a barrier between women and an insidious social force that’s been pushing down on us for a very long time. Financially speaking, it will not be free, and I apologize for getting caught up in the excitement and failing to emphasize that caveat. But it seeks to reduce that burden of special oppression women have experienced just for being women. It’s a step toward what we mean by “freedom.”


  1. The Other Anne says

    A large number of comments I’ve read complain that people who don’t want birth control will “be paying for those who use it,” and implying that women who use birth control are lazy and selfish and unwilling to pay their part or whatever. Which is utterly ridiculous. Because if their complaint is “why should birth control be covered for people who use birth control when I don’t use birth control so now I have to pay for them?” It’s an entirely irrational comment which ignores the fact that assuming every person paying insurance pays for everyone else’s medication through their own insurance, those who pay for insurance are ALWAYS paying for medication or procedures that they might not personally use. So what’s the difference between those and birth control?

    I also read an incredibly awful piece which claims that the USA will go extinct or something if “we let women get free birth control.” LOLWUT? The ONLY POSSIBLE reading of that I can think of is that this person thinks that the population of a country is ONLY EVER continued by forcing women to have children against their will. And I would like to say: if the population of this country dies out because women ARE CHOOSING FOR THEMSELVES not to have children then GOOD because THEY ARE DOING WHAT THEY ARE CHOOSING TO DO. My purpose in life IS NOT to perpetuate the population of the USA. My purpose is whatever I CHOOSE it to be. UGH, I could not BELIEVE that. Because also NO WOMAN EVER wants children. No siree, we all have to be forced into it.

    Anyway, thanks for the followup.

  2. says

    The Other Anne: those who pay for insurance are ALWAYS paying for medication or procedures that they might not personally use. So what’s the difference between those and birth control?

    Great point. And the only answer can be: misogyny/sexism. Because here’s a question for those who think women who don’t want to pay for birth control are selfish: aren’t men benefiting from women using bc, too? Aren’t a lot of husbands able to enjoy sex with their wives more because they’re not relying on some dodgy rhythm method to prevent the birth that will push their family solidly down into abject poverty? Why should only women be paying for that?

    And doesn’t ALL of society pay for unwanted children in some fashion? It’s like the argument that I shouldn’t be paying taxes that fund public schools if I don’t have kids in them. But without public schools, we’d be surrounded by an even more ignorant populace than we’ve already got, and that’s not to my benefit. (This is separate from arguing that schools aren’t doing their job, which is a whole other valid issue.)

    Re: the other article you mention. Um… how many billions are spent by couples trying to overcome fertility problems and have a child each year? And hey, the article also seems to presume that it would be a really bad thing if we became extinct. How so? First of all, we won’t be around to care, right? Second, species become extinct daily. Someday it’ll almost certainly be our turn. So what?

    Really, all the characters populating your comment there have one thing in common: they need to take A Brief Introduction To How Life Has Always Worked Get Over It 101.

  3. says

    So people are annoyed at having to pay the costs of some other woman’s birth control, but they’d be just fine with having to pay the costs of that woman’s (unwanted, unplanned) pre-natal care, delivery, and all the insured health costs of a covered child up to age eighteen…? Right, because that would be so much cheaper. [sigh]


  4. sbg says

    The Other Anne,

    I honestly don’t think many understand how insurance works at all. Like, seriously, they think companies are just being mean when they raise the premiums. Uh, no, it’s not personal. It means that in your pool, there was heavy usage and/or several catastrophic claims, etc. Just because your out of pocket max protects you personally from paying $600,000 + doesn’t mean the plan isn’t dinged for it.

    Basically: we need to keep reinforcing what you have just stated over and over and over until more people get it.

  5. says


    I can believe this (that people just don’t understand how it works). In which case there must be some reactionary pundits telling them the misleadingly selective truth that everyone will be paying for birth control.

  6. MaggieCat says

    The Other Anne:
    I also read an incredibly awful piece which claims that the USA will go extinct or something if “we let women get free birth control.” LOLWUT? The ONLY POSSIBLE reading of that I can think of is that this person thinks that the population of a country is ONLY EVER continued by forcing women to have children against their will.

    I’ve heard that idiotic argument too, and you know what’s a funny coincidence? I’ve never heard it from someone who wasn’t white. So they’re conveniently ignoring that fact that their own “American” family is descended from immigrants, which points pretty strongly at another hateful line of thought.

  7. says

    Do socialized medicine countries like the UK not provide free birth control? I’ve found forums where visitors to the UK are advised they can pick up free pills at NHS walk-in centres. Another states that France partly or fully reimburses women for both the doctor visit and the pills themselves (partial reimbursements are for more expensive pills).

    Considering France is doing better than we are with this recession, despite concerns they had a few years ago about falling birth rates, I’d say their status puts the lie to concerns that our “going extinct” (read: birth rate falls a little, oh noes!!!) would create any real problems.

    Besides, if the birth rate falls right now, it’ll be because of the recession, not the pill. If so few of us are able to buy non-necessities right now that businesses are in trouble, who can afford to feed a new mouth?

  8. Em says

    If they’re so worried about paying for treatments they don’t use, why not complain about paying for all the COPD and cancer treatments, nicotine patches, etc. for smokers who managed to get insurance through an employer or something? Or for all the various medical expenses for people who got injured after voluntarily participating in a sport? Or any of the probably thousands of other treatments they will never, ever need? By this logic, women shouldn’t have to pay for prostate or testicular cancer treatments, because we don’t have prostates or testicles. Yeah, I’d say they don’t know how insurance works. Or don’t care and just want to make an exception in this case…

  9. says

    Jon Stewart had a nice little segment about this on The Daily Show the other night. He played a clip of a Fox News anchor saying, “If you can afford a $5 frappuccino, you can afford a $5 copay.” Then back to JS who deadpans, “What if you can’t afford a $5 frappuccino but still have genitals?”

    Which goes to show the classist and ableist assumptions inherent in this debate, too. I mean, I don’t buy Starbucks. I have a frickin’ coffee maker and I buy off-brand beans. There have been times in my life when $5 was my food budget for the entire week. Ramen ain’t popular cuz it’s healthy! The Pill isn’t about sex for me; I would love to have the luxury of buying supplies for my sex life. The Pill is what makes me not curled up around an ice pack in the fetal position, crying, for days at a time. Turns out your ovaries slowly committing suicide frickin’ hurts. Who knew? Not Fox News, apparently.

    Em: By this logic, women shouldn’t have to pay for prostate or testicular cancer treatments, because we don’t have prostates or testicles.

    Precisely! Hell, don’t most insurance policies cover Viagra? I have to stop and marvel at the bald-faced hypocrisy that foams at the mouth over Yasmine, which regulates your period, while ignoring Viagra, which gets you hard. I mean, if we’re going to tie a behavior to a medication… (And yes, I realize Viagra is prescribed for non-sexual reasons. So are Yasmine and other HBC’s.)

  10. says

    I.A. Scott,

    Thanks for the info!
    Sylvia Sybil,

    I am so far beyond sick of allegedly educated intelligent people either not knowing about disorders that affect tons of women and require bc pills (PCOS alone affects about 25% of women), or knowing but not giving a damn. That’s why I say they want women to die of cancer – if you can afford to go on national airwaves and spout your brain product, then you can afford to be held responsible for realizing you just argued that women should die if they can’t afford the pill.

    $5 fucking copay – any plan with that low a copay is going to cost many hundreds a month for an individual. That’s way out of reach for individuals and even small businesses, so only by working for a medium sized company or bigger can you get in spitting distance of a copay that low.

    Fox News is basically just hate speech, and Rupert Murdoch has the ethics of a serial killer and has passed that attitude all the way throughout his organization, which is why the phone hackings are totally his own goddamn fault and he deserves prison for it.

  11. says

    Jennifer Kesler,

    Jennifer, I can speak to the Canadian situation, and no, we don’t have free birth control widely available. But, we do have a fair number of organizations who work to make it available cheaper, most notably Planned Parenthood. It’s generally not very expensive, and the prevalence of drug-plan benefits is, I think, higher here too, so for most full-time employed people, and for those receiving public assistance, there are income supports for paying for bc, so while it’s not free, it’s often subsidized. I pay about CAD40/month for my HRT, which is basically birth control pills.

    Being self-employed, and not yet in a position to afford my own benefits, I currently go without, which means in the Canadian system that I must pay for or go without the following:

    – non-emergent dentistry
    – optometry not related to diagnosed illness (such as diabetes)
    – medications
    – elective procedures
    – doctor’s notes/filling out forms/phone prescriptions
    – chiropractic, massage therapy, or alternative medicine therapies, largely

    Doctor’s visits, emergency dentistry, and all emergent care are covered completely. We don’t receive a bill; the doctor/hospital bills the government directly. If we go abroad, we have to purchase travel insurance, which covers the difference between what the provincial plan will pay for emergent care and what the bill is.

    For this munificence, I pay no more than my regular taxes. And if I pay enough (about CAD300/month), I can get help with paying for meds too under a government plan (Trillium, here in Ontario). And our income taxes are actually quite reasonable. I don’t know a lot of people who complain about them, but then I hang out in pretty leftist circles.

    It’s a pretty good system.

  12. Patrick McGraw says

    …wouldn’t covering non-emergency dentistry drastically reduce the amount of emergency dentistry that needs to be done?

  13. says

    Patrick McGraw,

    Believe me, a point I’ve made many a time. I have about twenty teeth left, because I’ve not been able to afford dentistry in the last, oh, twenty years or so. It’s the one big hole, and I never understand it: why does our health care stop at the gumline?

    *shrug* I don’t know, honestly. It’s weird.

  14. Musereader says

    Contreception is availible for free here in the UK, I should know, I’m on it! When I had Dianette I had to pay prescription for it (£7.40), because it was for acne, not birth control. Now i get Cileste and it’s wierd that despite the fact that I am still not using it for birth control, (painful periods) it’s free because birth control is the ‘only’ thing it’s for(!?). Most of the women I know are on some kind of contreception or another, injection, pill, coil, I’ve had the morning after pill free once and I know where to get free condoms from, especially in manchester. Not that I’ve had cause to get any in the last 3 years.

  15. Robin says

    Where is this magical $5 co-pay? I work for a non-profit and we have the cheapest HMO we could find. Yet I still have a $20 co-pay for routine things (annual physicals, biennial eye exams, etc.) and a $2,000 deductible for non-routine (ER visits, hospitalization, new glasses that I need in order to see anything ever).

    I think the local-taxes-funding-public-schools analogy is a good one. It takes things out of a medical context entirely. That said, the reason these people are getting bent out of shape about paying for “every woman’s” birth control when they don’t care about paying for some old guy’s boner or heart medication is the same reason they specifically forbade abortions being funded with federal funds. They want to control women’s bodies. Whether they cloak it in the language of “protecting society” or “saving the unborn babies”, they are still trying to take away our bodily autonomy, and I’m glad that this bill is a step away from that way of thinking.

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