by Cathy Deeds
March 3, 2000
The National Abortion and Reproductive Rights Action League (NARAL) issues an annual summary of legislative activity entitled "Who Decides: A State-by-State Review of Abortion and Reproductive Rights." This year's summary notes that 1999 had the highest number of "anti-choice" (read: pro-life) laws enacted since NARAL began tracking them in 1991. The most common new laws include: state funding ban on abortions and/or counseling and referrals; abortion clinic regulations; and parental notification laws. This is good news for pro-lifers in many ways, but there is a disturbing trend in "pro-choice legislative activity."
The "most significant" legislative trend noted and supported by NARAL lies in "contraceptive coverage laws," which are gaining acceptance in many state legislatures. The measures are backed by NARAL, Planned Parenthood, and other pro-abortion groups that have long lobbied for more funding and access to contraception -- under the false assumption that contraception helps reduce unintended pregnancies and abortions. These new "coverage" laws go much further, forcing these groups' agenda on unwilling health care providers and individuals who may not see all "contraceptive" methods as equal.
When state legislatures take up these proposals, pro-life groups -- especially those without a public position on contraception as such -- are often caught off-guard. In 1998 Maryland became the first state to require "comprehensive" contraceptive coverage. In 1999, according to NARAL, 67 state bills requiring insurers to cover contraceptives were introduced in 34 states (compared to 31 bills in 19 states in 1998). Nine states have enacted such laws (CA, CT, GA, HI, ME, NV, NH, NC and VT), and several others are debating them this year.
The laws are often modeled after a federal bill (not passed by Congress) known as the Equity in Prescription Insurance and Contraceptive Coverage Act (EPICC) -- and most of the state bills use this same name. They force private health insurance plans and/or employers who pay for prescription drug coverage to cover all "FDA-approved" methods of contraception, regardless of the patient's age, gender or marital status, and regardless of the provider's conscientious objection or long-standing religious beliefs against such coverage.
According to the American Association of Health Plans, 93% of HMOs already provide contraceptive coverage. A 1999 Kaiser Family Foundation survey of employee benefits found that "80% of HMO's for companies of any size offer an oral contraceptive benefit and 58% offer reversible contraceptives" while "only" 64% of Preferred Provider Organizations (PPOs) cover oral contraceptives. Obviously Catholic plans, along with some other religiously affiliated and even secular plans, do not. But these data indicate there is no shortage of plans covering contraceptives for people who want such coverage. The only purpose of the laws being pushed by pro-abortion groups is to force such coverage on plans, employers and families who do not want it.
The Church objects to contraceptive coverage laws not only because it has moral objections to contraception itself, but also because such laws violate fundamental principles of religious freedom and freedom of conscience. They force all participants in the private health care market (health plans, employers and consumers/patients) -- many of whom are Catholic and people of other beliefs who oppose abortifacient drugs -- to provide or at least pay for all types of "contraceptive drugs and devices," as defined by the U.S. government. These include so-called "emergency contraception," which is typically administered up to 72 hours after intercourse to destroy a developing embryo. This has been approved as a method of "contraception" by the FDA. Catholics are not the only ones objecting to such mislabeled "contraception." As two respected physicians observe in the February 2000 issue of the American Medical Association's Archives of Family Medicine (www.archfammed.com), it violates women's right to informed consent to simply call such drugs "contraceptive."
At the federal level, a slightly more modest mandate was included as part of the 1999 and 2000 Federal Employees Health Benefits (FEHB) program for federal employees. The U.S. Catholic Conference opposed the mandate, then worked hard to obtain conscience protection so health plans and individual providers who object on religious or moral grounds could opt out. In large part that effort was successful (though Congress limited protection for health plans to "religious" grounds). But few if any state laws contain properly written conscience clauses. Such protection is sorely needed, or "freedom of choice" will become a mask for oppressing freedom of choice and freedom of conscience.
Federal and state governments should not act as agents of the pro-abortion lobby, requiring Catholic and other health plans to cover items which they oppose on moral and religious grounds. We can be certain that this lobby will attempt to mandate other controversial "reproductive" services to mainstream them into the health care market by force. Let's be aware of what's going on and fight back to protect our beliefs, before it's too late and we have no choice.
Cathy Deeds is a public policy analyst in the Secretariat for Pro-Life Activities, the National Conference of Catholic Bishops.