Here’s a little thought experiment.
Suppose a lot of companies in the U.S. started offering car insurance as a benefit of employment. Then suppose Congress passed a law requiring all companies to do so. And then suppose the White House decreed that, under the new law, employer-provided car insurance policies must cover the full cost of preventive maintenance, including replacing worn-out brake pads for free.
You could make a case for the brake-pad mandate. You could say it would prevent collisions, save lives, and lower medical expenses. You could point out that brake pads are not a frivolous luxury, like leather upholstery, but a vital necessity. You could cite surveys showing that fully 100 percent of motorists rely on brake pads to keep from getting hurt or killed on a daily basis. And you could note that brake pads cost a fair amount of money, so paying for them puts a dent in a driver’s budget.
What you could not do—at least not without inflicting grievous bodily injury on the English language and basic logic—is contend that a company which preferred not to provide brake-pad coverage to its employees was somehow denying people access to them. After all, those employees could still walk into any mechanic’s shop, Pep Boys, or Advance Auto Parts and buy all the brake pads they wanted.
Indeed, millions of Americans have bought their brake pads in just that way for many years. So you could not pretend the company was “taking away life-saving devices from its motoring employees,” or “denying automotive care to people who need it.” And you certainly could not argue that the company was “imposing its anti-brake pad views” on anyone else. It was not telling employees they could not buy brake pads themselves. It was simply declining to pay for them.
And yet last week countless seemingly intelligent people made just such arguments about the Blunt Amendment, which would have created a conscience exemption from the insurance requirements of the Patient Protection and Affordable Care Act. The amendment was introduced because Catholic institutions such as hospitals and universities objected to paying for contraception, as the Obama administration has required them to do. (The administration has offered a “compromise,” but it is an accounting fiction, especially for those institutions that self-insure.)
According to former DNC chairman and current senatorial candidate Tim Kaine, the Blunt Amendment would have let employers “deny any preventive service to any employee.” According to Jim Webb, the Virginia senator whom Kaine hopes to replace, “any stakeholder could decide to deny health care benefits to any individual.” Maryland Sen. Barbara Mikulski repeated the talking point, fuming that the amendment would allow companies to “deny coverage for any service they choose.” Senate majority leader Harry Reid joined in, too: “The Blunt Amendment would allow any employer or insurer to deny coverage for virtually any treatment for virtually any reason.”
Even the ACLU, which usually stands up for religious freedom, let politics override its principles. “Religious freedom,” it insisted, “does not give religious groups the right to impose their views on others.”
This is Orwellian doublespeak of the first order. It is like saying that if Harvard University does not provide every employee with a free subscription to People magazine, then Harvard is forbidding employees to read it. Absurd. You can get People magazine in any drugstore—just like contraception.
Consider what could happen now that the Blunt Amendment has failed. Some Catholic institutions may decide to drop insurance coverage for their employees altogether, and pay the $2,000-per-worker penalty as stipulated in the PPACA. What’s more, non-Catholic employers might one day decide, on the basis of a simple cost/benefit analysis, that they are better off dropping coverage and paying the penalty, too—contraceptive mandate or not. They don’t even have to claim a conscience objection. They can simply “pay and walk away.”
For that matter, the PPACA’s insurance mandates do not apply at all to small companies with fewer than 50 employees. Not only are such businesses not required to provide coverage for contraception and other preventive services—they aren’t even required to provide coverage for chemotherapy or emergency-room trauma care.
If Kaine, Webb, Reid and the ACLU are right, then it is not just the Blunt Amendment that allows employers to deny any health benefit to any individual for any reason. Obamacare does the very same thing.
Unfortunately, it also hogties companies with a host of other mandates and rules and requirements that the federal government has no constitutional authority to impose in the first place. The problem with Obamacare is not that it requires companies to provide insurance coverage for contraception. The problem is that it requires companies to provide insurance, period—and requires individuals to buy it, not as a condition of driving as with car insurance, but as a condition of breathing.
That is why the Blunt Amendment was not far too broad but far too narrow. A much better amendment would have read: "The Patient Protection and Affordable Care Act of 2010 is hereby repealed."
A. Barton Hinkle is a columnist at the Richmond Times-Dispatch, where this column originally appeared.