Friday, February 17, 2012

You mean it’s not possible to provide contraception insurance at no cost to … anybody?

Well, duh. What’s crazy is that the administration has ever tried to say otherwise. Fortunately, insurers aren’t afraid to state the obvious. Hidden — or not-so-hidden — in the administration’s insistent mandate that insurers provide coverage for contraception to the employees of religiously-affiliated organizations is a very real cost:

    The administration has said insurers should ultimately make up any initial costs by avoiding expenses associated with unintended pregnancies. But a new survey of 15 large health plans shows they are dubious of such savings.

    Asked what impact the requirement will have on their costs in the year to two years after it goes into effect, 40 percent of the participants said they expect the requirement will increase costs through higher pharmacy expenses.

    The survey of pharmacy directors at the health plans was conducted on Wednesday by Reimbursement Intelligence, which advises pharmaceutical, medical device and other companies on reimbursement issues. The firm did not name the insurance plans it surveyed.

    Of the health plans, 20 percent said costs would even out because they already budget for contraception in the premium, 6.7 percent said it would drive up pharmacy costs but decrease medical costs, while 33.3 percent weren’t sure. None said it would lead to net savings.

Nobody should be surprised by this, not least the president, even if he did recently try to sell the mandate as driven by a desire to lower health care costs. Apparently, the administration actually prohibited the panel of health-care experts commissioned to craft a list of recommended preventive services — the list that ultimately led to the contraception mandate — from considering cost-effectiveness. So, they didn’t — and predictably recommended that the administration mandate coverage of contraception.

Let’s think about this for a minute: Insurers expect this to increase their costs. Will they just swallow that increase or will they — oh, I don’t know — raise premiums? Once again, I’m reminded that it sucks to be a conservative because we have to be the ones to say fun facts like this one: There’s no such thing as a free lunch.

The conservative talking point on this issue so far has been this: “This isn’t about contraception. This is about religious liberty.” Let’s take that one step further: “This isn’t about religious liberty. This is about plain ol’ liberty.” Even if I were the biggest proponent of contraception in the world, even if I spent my weekends passing out condoms to college kids, even if I spent my days pleading with my female peers to pop the pill, I would still say no one should be forced to subsidize another person’s contraception.

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