Just Because You Think It’s a Good Idea Doesn’t Mean My Insurance Ought to Pay For It

I want to take this on now. Kevin Drum cites a Washington Post article about an advisory panel’s recommendations, now under consideration by Health and Human Services, that health insurers be required to pay all of an insured’s costs for prescription birth control. According to the WaPo article, Jeanne Monahan at the Family Research Council voiced concerns that some insured might object on religious grounds to paying for birth control through their insurance premiums. Kevin derisively casts Monahan’s stance as

Everyone should have the right to insist that they be covered by an insurance company that doesn’t cover anything they disapprove of for other people.

Well, if this means the right to choose from among different insurers based on what you like or don’t like about their coverage, that seems all right to me. I don’t think that’s the actual policy question here. All most religious conservatives would expect is that health insurers be allowed to refrain from covering things that a large number of insurance customers might not consider essential or proper health care services.

I think religious objections are worthy of consideration, but free-market objections might have more weight. Insurance should not cover things that almost everyone can manage to choose, plan for, and pay for out of their own pockets. This especially applies to services that some significant cultural group would avoid using even if it was paid for by insurance. Even if no one had a moral objection to someone else’s use of contraceptives, that still would not mean that everyone would be happy with having their health insurance plan bear the cost. I can pay for my own contraceptives, if and when I decide I want them; let others do the same. (Similarly, I buy my own running shoes and other fitness equipment. No health insurance coverage on those, yet.)

I understand that there’s some reasonable basis for treating birth control as preventive care. It makes good sense for those responsible for paying for a person’s health care to nudge that person into taking inexpensive steps now to head off more expensive health issues later (like a pregnancy). I do wonder why anyone thinks an insurer has to be required to pay for such things, when it is so plainly in the insurer’s financial interest to do so.

If the thinking is that some insurers might be swayed by religious groups to leave birth control uncovered, I say let’s let them be swayed according to how they gauge their customers’ preferences. Must we always demand that commerce serve to advance some centrally determined code of justice?

[Update: edited typo “oost” for “cost”.]
[Later update: another typing/wording fix: “understand there some” -> “understand that there’s some”.]

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