Very possibly one of the worst aspects of the Affordable Care Act—aside from its having raising health insurance prices, constricted the health insurance market, destabilized that same market, done serious damage to our constitutional order, and a few other similarly minor considerations—is the effect it has had on the popular perception of American womanhood. Public opinion of American women now seems to be: before the Affordable Care Act women were terrified, helpless waifs, buffeted by the heartless winds of a merciless pre-Obamacare marketplace and social landscape. Consequently, this opinion holds, if the Affordable Care Act is repealed, then women will be put into a perilous situation wherein their saving grace legislation will have been ripped away from them and they’ll be on their own. Don’t take it from me, take it from the Washington Post, which argues that “The Trump administration’s birth control overhaul could do serious harm:”
The draft of a proposed regulation, dated May 23 and obtained last week by Vox, would dramatically overhaul the government’s contraception coverage mandate. It would, if finalized, expand the exemption that currently applies to religious organizations and private employers with religious scruples to any employers or insurers expressing “religious beliefs and moral convictions” against birth control. No formal notification to the federal government would be required. “Moral” is not defined. And even for-profit, publicly traded companies would be able to lay claim to moral convictions. “The rule essentially would allow any employer to drop birth control coverage in employee health plans virtually at whim,” wrote Michael Hiltzik of the Los Angeles Times…
Without insurance — which, it should be noted, women pay for — birth control can be out of reach. A recent survey from PerryUndem found that 33 percent of women could afford to pay only $10 or less out of pocket for oral contraceptives, and 14 percent said they couldn’t afford to pay anything. Before the mandate went into effect, co-pays ranged from $15 to $50 a month. Again, this is of little concern to the Trump administration, which argues in the draft proposal that women can turn to federally subsidized family planning programs, a maddening if not insulting argument since the administration has also proposed cuts in Medicaid. Moreover, if Republicans had their druthers, Planned Parenthood, the main source of birth control for low-income women, would lose federal funding.
As an aside, the survey that the Post found that 33 percent of women could only afford $10 or less “if they needed it ‘today‘,” which is an entirely different consideration from, “at all, ever.” But maybe the Post didn’t think that was an important distinction.
In any case, the Post is mad: “Never mind,” the editors write, “the scientific studies showing that as the use of contraceptives increases, the rate of unintended pregnancies decreases. Or that the decline in the rate of teen pregnancy in recent years is believed to be a result of the greater availability of free long-term reversible contraceptives.”
Yet note what is so terminally absent from virtually every public debate about birth control that we have in this country: the notion that a woman, if she is unable to lay her hands on some birth control, might be able to—I don’t know—avoid having sex. Every contraception debate we’ve had over the past seven years or so has apparently started out with the presumption that women are incapable of exercising sexual restraint in the event that they’re unable to have contraceptive sexual intercourse. It’s just not something women are able to, you know, do.
This is the political landscape that the Affordable Care Act has wrought: a national public policy presumption that women are helplessly unable to control their own sexual urges and desires in any really effective way at all. It would be beyond the pale, I guess, for someone to say, “Hey, ladies, if this highly expensive and ineffective health insurance law is repealed, and you suddenly find yourself without an IUD or a pack of pills for a while, be careful and maybe don’t have sex if you don’t want to get pregnant.” Perish the thought: such a declaration, if it came from anyone of any consequence (present company excluded), would be a national scandal. In any event, I, for one, believe that women are more than capable of making smart decisions without the help of the federal government when it comes to both contraception and sex. It is odd that, in this day in age, such an opinion apparently makes you out to be a retrograde sexist.