So, it begins with the acceptance of two appeals masquerading as objections to the ACA health insurance mandate to include contraceptive coverage.

Hobby Lobby wants all the protections and advantages of being a corporation and also a church.  (The latter would be too big of a stretch if that ACA health insurance contraception mandate hadn’t included a religious exemption.  As if “conservative” religious folks shun contraception for themselves.)
This question was settled by the public.  Rush flipped out over the contraception mandate and lost sponsors.  And there is no Senator Akin and Senator Mourdock.  But that’s not good enough for the rightwing nutjobs that insist on further clogging up the courts for their right to impose their beliefs on others.  The legal and ethical arguments against Hobby Lobby have been adequately addressedThe ACLU and Planned Parenthood.
What’s left out is the economic consideration.  Health insurance companies may be too small for their actuaries to calculate and explain this in dollars and sense.  So, a small thought experiment is required.  

First imagine that this country is evenly split – 50/50 and regardless of age and gender –  between those that agree and disagree that health insurance should include contraception.  Then everyone could make a personal lifetime choice as to whether or not their health insurance included contraception.  Mandate that health insurers not mix these two pools of policyholders for determining premium prices.  All other things being equal, would the premiums be the same or would one cost more?

If the Hobby Lobby CEO were told that the price without contraception coverage was $3,500 and with contraception coverage $3,000, would his “religion” be important enough to pay an additional $500/employee/year?  Fat chance.  If he’s successful with the SCOTUS Catholic mafia, would he be satisfied that his employees’ health insurance costs the same as what other employers that include contraception pay?  Probably not.  He’s likely thinking that less coverage means less cost to him.

That’s simply not true for low cost, ordinary medical care.  Even for chronic conditions such as Type II diabetes that is as much related to lifestyle choices as unintended pregnancies.  The ACA gets this one thing right.  Contraception is cheap and cost effective.  

Beyond political lobbying by the AMA and health insurance companies that thwarted Teddy Kennedy’s national health care efforts during Nixon’s presidency, there was some evidence that the private sector was doing fine managing our health care system.  Aggregate (national) costs weren’t rising by all that much.  Well, duh!  Who could have predicted that the introduction of birth control pills and women gaining legal reproductive rights to family planning and access to affordable reproductive medical care would be a cost and social win-win?  Is it merely coincidental that when the religious nutcases began to succeed with their efforts to deprive women of the rights they had gained during the 1960s and 1970s and stop contraception research in its tracks that total medical care costs began to outpace aggregate inflation?  

As if the US “baby bust” had no economic impact.

The total fertility rate in the United States after World War II peaked at about 3.8 children per woman in the late 1950s and by 1999 was at 2 children. This means that an imaginary woman (defined in the introduction) who fast-forwarded through her life in the late 1950s would have been expected to have about four children, whereas an imaginary woman who fast-forwarded through her life in 1999 would have been expected to have only about two children in her lifetime.

Note, however, that the US fertility rate dropped to 1.8 during the 1975-79 period.  The peak period of choice.  When allowed to choose, almost all women are practical and responsible.  

At one time, Republicans balanced their hatred of poor women with lots of children by supporting Planned Parenthood, including access to safe and affordable abortion.  There wasn’t anything noble about those old Republicans.  Their position merely combined their eugenicist leanings with loathing for public social services.  It was nothing but self-centered pragmatism.  A pragmatism that melted away as soon as they discovered that religious wackos preferred that women be kept barefoot and pregnant.  And they take zero responsibility for what this has wrought.

In this area the ACA made the right step.  Not a big enough step nor the most cost effective step.  Timid rather than bold.  Federally funded Planned Parenthood coast-to-coast and free to patients for all reproductive health care services, including birth control pills and abortion, would have cost less, but as neo-liberals continuously remind we wooly-headed dreamers, that isn’t pragmatic.  

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