There has been a lot of press on the recent announcement by the Department of Health and Human Services (HHS) that it was finalizing the rule requiring coverage of all FDA-approved contraceptives with no co-pays or deductibles, and a lot of it hasn’t been positive.  Most of the focus has been on the fact that the Administration chose not to expand the exemption for certain religious employers.

Take Michael Gerson’s and E.J. Dionne’s recent op-eds, for example. Both of them admonish President Obama for not expanding the religious exemption to entities like religiously-affiliated hospitals and universities, and Gerson says that the rule covers “abortifacients” which is just wrong. He also concludes that the decision on the final rule means that “war on religion is now formally declared.” The way these two see it, it should have been a no-brainer to expand the exemption. But wait just one minute, is this all the rule is about – religious institutions versus the Administration? Is there anything else that maybe we should be considering when analyzing this rule?

Oh right…. the tremendous health benefits of contraception. Oddly and sadly, these health benefits are blatantly ignored in all of the negative commentary (Dionne tips his hat just a bit by vaguely referring to how the rule protects “women’s rights”). So it got me thinking, maybe they just don’t understand the health benefits. Maybe I should take a moment to explain just how critical contraception is as a preventive health service. So Gerson, Dionne, and all of the others who ignore the real issue at stake, please take notes.

Sometimes women can have cysts on their ovaries (one woman’s story is in a great NYT article). Many times a woman won’t even know about the cysts until one bursts, causing horrible pain. So what to do to deal with these awful cysts? Contraception to the rescue! Birth control keeps the cysts in check, preventing future ruptures. So that’s kind of a big deal. OK, what else? Oh, right, contraception helps women time pregnancies, which both lowers the risk of adverse perinatal outcomes and prevents a range of pregnancy complications. What does this actually mean? First, being able to space your pregnancies apart decreases the risk of lower birth rates, preterm birth, and small-for-size gestational age. We’re talking about healthy babies here, folks. Not to mention healthy women. Timing a pregnancy can also be critical to women, as it can prevent a range of pregnancy complications like gestational diabetes, high blood pressure, and placental problems. These are real, tangible benefits of contraception. They matter, and the op-eds and articles that completely ignore them are insulting to women and families.

So why ignore these obvious health benefits? Any why focus only on the religious freedom of corporate entities (not churches, mind you, they were already exempted under the interim rule) when they’re already employing people of all religions, all with their own individual consciences? Why not focus instead on the fact that expanding this exemption would excuse discrimination against women? And, if this were really about the violation of “institutional conscience”, weren’t employers’ “consciences” already violated when they paid salaries to female employees who subsequently used them to pay for contraception? Why is the health insurance coverage of contraception any different from paying a woman her salary? Oh my, what a slippery slope they are on.

And, even more critically, the op-eds also seem to keep ignoring the fact that this rule is not about requiring someone to take contraception. This is about covering contraception in health insurance plans. A woman uses her own moral compass to decide whether to use contraception. (And women resoundingly come down on the side of contraception. In fact, 99 percent of all women and 98% of Catholic women use contraception at some point in their lives. The conscience here is the woman’s, not some corporate entity.  

So, please take a moment and let the Administration know that you appreciate and support the final rule. Give them a hearty ‘thank you,’ and let them know that contrary to what the op-eds and pundits say, America stands with women’s health!

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