In a story about legislation aimed at modifying the Obama administration's requirement that health plans cover contraception and sterilization, The New York Times once again reports the president's spin as fact (emphasis added):
Under the administration policy, most health plans must cover birth control for women — all contraceptive drugs and devices approved by the Food and Drug Administration — as well as sterilization procedures.
Church-affiliated universities, hospitals and charities would not have to provide or pay for such coverage. Instead, the White House says, coverage for birth control could be offered to women directly by their employers' insurance companies, "with no role for religious employers who oppose contraception."
[Sen. Roy] Blunt said, "The president's so-called compromise is nothing more than an accounting gimmick."
Why does Blunt call the purported compromise an "accounting gimmick"? Times reporter Robert Pear never explains, perhaps because that would force him to admit it's not really true that "church-affiliated universities, hospitals and charities would not have to provide or pay for such coverage." The day after President Obama announced his alleged accommodation, Harvard economist Greg Mankiw noted that it did not change the essence of the policy:
Consider these two policies:
A. An employer is required to provide its employees health insurance that covers birth control.
B. An employer is required to provide its employees health insurance. The health insurance company is required to cover birth control.
I can understand someone endorsing both A and B, and I can understand someone rejecting both A and B. But I cannot understand someone rejecting A and embracing B, because they are effectively the same policy. Ultimately, all insurance costs are passed on to the purchaser, so I cannot see how policy B is different in any way from policy A, other than using slightly different words to describe it.
Yet it seems that the White House yesterday switched from A to B, and that change is being viewed by some as a significant accommodation to those who objected to policy A. The whole thing leaves me scratching my head.
Even Washington Post columnist Ruth Marcus, who applauded the rhetorical shift, acknowledged this reality:
This is, of course, a dodge — a quite clever and positive one. Everyone gets to say that the religious institutions aren't "paying for" contraception. But if covering contraception ends up costing them money, you can be sure those costs will be passed along, as costs always are, to customers.
Marcus then echoes the administration's argument that the contraceptive mandate may not result in higher premiums because it will save insurers money on pregnancy-related health care. If so, of course, that would have been true under the original version of the policy as well. In his congressional testimony on February 16, Catholic University President John Garvey questioned the cost-saving argument (which he dubbed the "Shazam Theory") but also said the net financial impact of the mandate is beside the point:
From a moral point of view, the administration's cost savings don't matter even if they are real. When a student who is enrolled in our plan purchases contraceptives at the local CVS pharmacy, CVS will seek payment from the insurance company. The payment for that service will be charged to our account, funded by our contributions. The Shazam Theory assumes that charges for other drugs and services will go down as a result of contraceptive use. But it is still true that the University and its subscribers are being forced to pay for sterilizations, contraceptives, and abortions [a reference to the possibility that some contraceptives may prevent implantation after fertilization], and those are activities we view as immoral.
I don't expect the Times to endorse these critiques. But it should at least clarify that the issue of whether church-affiliated organizations still have to pay for birth control coverage is contested, and maybe even explain why. Here is a short version:
The Obama administration says its new policy means church-affiliated universities, hospitals and charities won't have to provide or pay for such coverage. Blunt says "the president's so-called compromise is nothing more than an accounting gimmick" because the cost of the coverage will be reflected in the premiums employers pay.
Here is an optional addition:
The administration says the contraceptive mandate won't raise premiums because it will save insurers money by preventing pregnancies. Even if that's true, critics say, church-affiliated organizations still have to pay for health plans that cover products and services they consider immoral.
Without such explanations, the continuing controversy will be unintelligible to the average reader.