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Do Conservatives Understand How the Female Body Works? The Myth Fueling the Right-Wing Freak-Out Over Birth Control

The Republicans' chosen narrative about Obama's contraceptive coverage betrays a total lack of understanding of the most basic realities of human reproduction.
 
 
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Not only doesn't it cost companies a single penny to provide free contraceptives to their employees, studies show they actually save almost $100 per employee per year when they do so. Anyone with even a passing knowledge of women's health – of how human reproduction works – understands this.

That's why, in the real world, the Obama administration's “accomodation” with the Conference of Catholic Bishops over contraceptive coverage should be seen as a win-win proposition. Women get contraceptive coverage at no cost, religious institutions with superstitions against interfering with the will of the Gods get to keep their hands clean of the whole affair and the media reported the whole kerfuffle as if the bishops still had some moral authority from which to speak.

Of course, sound public policy has never stood in the way of a flood of conservative outrage being spewed at a Democratic administration. The right is up in arms, and Republicans in Congress have chosen to double-down on the issue. But their chosen narrative is unusually wrong; it in fact betrays a total lack of understanding of elementary biology.

Their gripe centers around the supposed “costs” of providing that coverage, and they're quite smug about it – as if they have a rare insight into some kind of shady scheme to get around religious objections. As the National Review's Hannah Smith put it, “religious employers would still ultimately be paying for these services against their conscience, with the costs spread through higher insurance premiums for their employees." That's totally inaccurate, but at Red State, Michael Hammond agreed, writing, "Catholic hospitals and universities would pay insurance companies premiums, which would pay for contraceptives.” He added, in 15th-century style, "Evil doesn't become good because it's laundered through a third party." Even Megan McCardle, the Atlantic's “business editor,” is woefully confused about this topic. "The insurers have to provide it 'at no cost',” she wrote, “which of course means the Church will still be paying for it."

This flies in the face of a large body of peer-reviewed data which show that, on net, providing universal contraceptive coverage to women is absolutely free of cost to insurers. As a Department of Health and Human Services analysis noted, “Evidence from well-documented prior expansions of contraceptive coverage indicates that the cost to issuers of including coverage for all FDA-approved contraceptive methods in insurance offered to an employed population is zero.”

And it's not difficult to understand why. Doctor Kelly Cullwell, a clinician and birth control expert at the UC Davis Center for Women's Health, told AlterNet that research into public health programs shows that “for every dollar spent on contraceptive coverage, you actually save close to four dollars in overall healthcare costs.” She added: “it's probably one of the most cost-effective preventive care interventions that we have.”

Studies from three actuarial firms – Buck Consultants, PriceWaterhouseCoopers, and the Actuarial Research Corporation – estimated the direct annual cost of the medication for insurers at between $21 and $41 per enrollee. In 2007, the average cost of giving birth to a child was $8,802, according to the Kaiser Family Foundation ( PDF).

That math should be pretty obvious, but the costs aren't the same for planned and unintended pregnancies. According to the Department of Health and Human Services:

Medically, unintended pregnancies are serious in terms of the lost opportunity to prepare for an optimal pregnancy, the increased likelihood of infant and maternal illness, and the likelihood of abortion.…The mother is less likely to seek prenatal care in the first trimester and more likely not to obtain prenatal care at all... The child of such a pregnancy is at greater risk of low birth weight, dying in its first year, being abused, and not receiving sufficient resources for healthy development.

 
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