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Sexually Biased Insurance Mandates: Concealed Taxes Set to Backfire


Proponents of the latest federal mandates on medical insurance, targeted solely at women, defend them with claims that they will save money, improve health, and reduce unwanted pregnancies. Such confidence in this lopsided government coercion is either naive or disingenuous.

A shift toward “preventive care” and fewer subsequent treatments is the supposed mechanism for cost savings. But that assumes, incorrectly, that political appointees know what reduces costs better than insurance executives.

Insurers already have an incentive to reduce costs while pleasing customers, so long as states allow competitors into the market. If the mandated policies achieved that, insurers would already offer them for free or reward participation with a discount on premiums. Evidently, applicable items such as contraceptives and “well-woman” preventive care visits do not save money for insurers.

On the other hand, insurance industry-leaders note that coverage mandates, particularly those that bar point-of-treatment pricing, increase unnecessary physician visits. To recoup the cost of those visits, insurers have no choice but to raise premiums for everyone. That includes raising them for individuals and employers struggling to afford coverage and for many observant Christians who morally oppose drugs such as the morning-after pill.

That such mandates ignore men is also perplexing, since their lifespans average five years shorter than women’s. Moreover, women tend to visit their physicians more frequently and generate far higher medical expenses. The bias in favor of women is more consistent with placating Planned Parenthood and certain pharmaceutical companies than with health goals, as Rep. Ron Paul (R-Texas) has noted. (And who could doubt the deep concern of federal officials for constituent health when they’re busy raiding raw-food co-operatives?)

Sexual bias aside, the imposed economic outcome of the new mandates is scarcely different from straight taxation and universal provision. They’ve just outsourced the provision and decided not to pay for it. Further, federal officials anticipate underuse of the mandated services and plan to promote their use, so we’ll pay for them to propagandize us as well.

Perhaps many people, though, are willing to stomach the increased intrusion and financial burden. As Vanessa Cullins writes for the Huffington Post, “There is no question that eliminating co-pays for birth control will help reduce unintended pregnancies.”

Really? Actually, the introduction of contraceptives has been more effective at changing sexual behavior away from marital exclusivity than preventing unplanned pregnancies.

Frank Colton invented the first oral contraceptive in 1960, and oral conceptives became legal nationwide in 1972. Uptake since then has been rapid, and approximately 80 percent of American women born since 1945 have used oral contraceptives at some point. A 2010 Centers for Disease Control report went so far as to describe broader contraceptive use in the United States as virtually universal.

Yet unplanned pregnancies remain persistently high — around 50 percent of the total — and between 1950 and 2000, the birthrate among unmarried women more than doubled. The CDC report identified simple misuse of contraceptives as a key reason for unplanned pregnancies. Greater provision won’t solve that.

Cullins views contraceptives as “critical” for the well-being of women — tell that to Catholics — so that they can have a greater chance at high-school graduation and establishing a career. But that connection, too, lacks firm evidence. Naturally, the young women likely to graduate with career prospects have a greater incentive to avoid pregnancy in the first place.

Gary Becker, a Nobel Laureate who led the field of family economics, argued that point in A Treatise on the Family — that reduced birth rates, where they are present, are explained by greater employment opportunities for women. In Japan, for example, oral contraceptives remained banned right up until 1999, but Japan still experienced an overall birthrate decline of 40 percent from 1950 to 2000. The United States and Japan do, however, share the common trend that more women are in the workforce.

So high birthrates are as much a symptom of poor prospects as they are a cause. An ever-heavier medical-insurance burden will only dissuade employers from taking on new staff, so the new mandates will hurt rather than help struggling young women.

Consequences be damned: Health and Human Services Secretary Kathleen Sebelius says that since birth control is the most common drug prescribed to women, health plans should make it available.

“Not doing it would be like not covering flu shots.” Perish the thought!

Translation: If you don’t give away these politically approved items for free to your clients, I will make you a criminal…. Tyranny of the majority — what is that?

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    Fergus Hodgson is host, editor, and founder of The Stateless Man radio show and e-newsletter and a policy advisor with The Future of Freedom Foundation.