Good work in this article, but it omits some of the most blatantly fallacious claims of the war on women's health care: that the "morning after pill" is, as the Hobby Lobby plaintiffs et al. insisted, an abortifacient and that other FDA-approved contraceptives cause abortions.
The Supreme Court's Hobby Lobby decision threw a protective mantle of unimpeachable religious "faith" over such claims, after repeated clinical studies have shown them to be empirically false beliefs. Calling a false belief a matter of religious faith should not be sufficient to win constitutional protection for it. Arguing for religious freedom didn't help the Mormons who wanted to practice polygamy, nor those who wanted to use hallucinogenic drugs to induce attain divine consciousness. Most important, SCOTUS' decision voided the moral conscience of the many women who use birth control in order to practice responsible child-rearing. These women's morally informed decisions have no protection against faith-based politicking.
As a result, anti-science now has the status of a religion, and moral reasoning is vitiated. Anti-scientific "values" voters have managed to secure Constitutional protection for their politics, even for profit-making corporations that can now base decisions about their employees' health insurance on whatever they wish to "believe." SCOTUS may know how to keep church and state separate but it has no intention of keeping religion out of politics.
Just because birth control is against some people's religion does not mean it is against everyone's religion. In a democracy with freedom to practice any religion, choosing to not provide a prescription medication to someone who wants it because it is against your beliefs, not there's, is unlawful.
'And the teenage pregnancy rate and teenage birthrate right now are at [record lows](https://www.cdc.gov/nchs/data/databriefs/db287.pdf) in the United States.'
Yes, but still by far the highest in the western world. In 2017, teenage pregnancy rates and teenage birth rates in the USA continue to be a disgrace.
1
I imagine we women could petition to remove all erectile dysfunction drugs from being insured and get contracts holding them financially responsible for any medical issues that arise out of their liaison signed by the male before taking off our clothing.
4
Science is not the problem, but hostility toward science by intellectually dishonest conservatives is. Conservatives have a delusional attraction to things not changing in ways they don't like, and their responses are equally nonsensical. Religion, the mythology of the bronze age, makes matters far worse, and conservatives often have a bizarre attachment to its dogma.
Trump, barely sane in many ways, is clinging to his supporters because only they will mindlessly ignore the incompetence and angry narcissism of this horrible person they voted for. So despite having no actual interest in contraception, he's acting on what he believes are the wishes of his low-information supporters to keep them happy.
The science behind the HHS new rule isn't just doubtful...it's fabricated to serve the agenda of the incompetent-in-chief, an agenda meant to overcome what he considers roadblocks to keeping his supporters pleased: the rule of law and checks and balances of process. His victims are women, a small price to pay for someone who has little regard for women beyond what he can grab.
Eclectic Pragmatism — http://eclectic-pragmatist.tumblr.com/
Eclectic Pragmatist — https://medium.com/eclectic-pragmatism
6
Why don't he and his wife have more children?
The removal of this subsidy for women will result in an increase in births as those who cannot afford it do not afford it. There will then be more children without needed life support who will live in poverty. Not all but many and that statistic will increase. Because the GOP wants to cut Medicaid those children will need to do without proper healthcare ..and there will be an increase demand for it from those who haven’t the wherewithal to pay. A smarter thing to do to benefit the nation is to pay for birth contro!
7
Ah...the cleverness of Trump voters!
3
"The percentage of those using long-acting birth control, however, has been increasing."
this CDC link refers only to birth control "pills" (estrogen and progestins together or progestins only), while other methods are obviously available like copper and hormonal IUDs and hormonal implants. part of science of birth control is specifying exactly what kinds we are considering and their effectiveness and side-effects. the link also refers only to "youth" or high school age people.
maybe part of the problem and the controversy is that we have one person (mr. trump) and one agency (the HHS) making private decisions for the whole nation. i can excuse a political appointee speaking about matters he does not know about, but the HHS as a professional agency should know better. but maybe that agency needs to follow the orders of authority, which can trump science (pun intended). however, in a government with checks and balances, congress can offer an alternative source of authority.
another problem is that sexual matters are highly emotional, so that people tend to forget objective science, and are often tied to religion--also a highly emotional, subjective matter--for reasons that i do not understand.
n.b. because men are also responsible in the cost of raising children and are the main drivers in sexual matters, men should also have an interest in birth control. men also have wives, mothers, sisters, daughters, nieces and cousines.
2
In my experience, women are the ones pushing to get married and have kids more often than men. I'm all for birth control, but blaming the whole issue of the need for birth control on men is pretty clueless.
I don't see men being blamed in the comment you are responding to. The point being made is that birth control is not just a women's issue, and that men need to remember that. The people in power making these decisions are men, but their position would be just as unacceptable if they were women. That said, too many decisions regarding women's health are now being made by a few men without any input from women.
The article indicates, "In addition to arguing against the positive results, the H.H.S. rule also argues that contraception is associated with negative health effects."
I am a physician. Good grief! Pregnancy has its health risks, including death!
I do not even know where to start. All medications have health risks.
Clearly, as noted by others, a fully anti-scientific ploy.
12
Please don't play down the health benefits of oral contraception, especially mood changes, such as ELIMINATION of depression and mood swings, decrease in painful periods, and reduction of cysts or tumors for women whose hormonal genetic predispositions for cysts an tumors can be manage through hormone adjustments by taking contraceptives.
This is a medical issue to be discussed between a woman and her doctor. The positive and negative impacts of hormones from oral contraception is not unlike the those of any medication and should be managed as such. This is not a matter to be regulated by government and their supporters who feel its their right to butt into and regulate the lives of others so that we all adhere to their standards and expectations.
As for risky behavior, give me a break. Smart people make smart choices, those who don't wont regardless of access.
6
Contraception works . That's what conservatives don't like.
9
I don't see the Lovecraftian horror in going back to the 2009 status quo regarding birth control insurance coverage for non-Medicaid enrollees.
It is not an attack on women's rights to suggest that women pay a co-pay for birth control just as men and women ALREADY do for furosemide, invirase, metformin, insulin, or leukeran among others. Those drugs treat conditions that are at least as or more serious than any condition treated by birth control. But if you need those drugs you must pay your co-pays. Why?
The mandate to force all companies and insurers to provide birth control in all instrances and with no co-pays was a politically motivated subsidy payoff for votes.
1
I and many others disagree.
1
Well, all this science is good, but we all know that is not the point. Controlling women's behavior is the point. And making them pay for it if they step over a line some sanctimonious arbiter of "morality" set up for women he doesn't know anything about. A line he is free to dance around any time he likes. Yuck.
30
Once again the Trump administration proves US exceptionalism.
6
I'll be interested to see how this goes down with the women who supported Trump when they lose contraceptive coverage.
To be fair though if one starts with the premise that employers shouldn't be forced to provide health coverage of any kind to anyone then the religious choice argument against contraceptive coverage is merely disingenuous. It gets the right closer to where they want to be but does not overturn the ACA as they really would like.
5
Changing your political thinking for ten bucks a month?
If that is enough to make American workers give up on a tax reform that might increase real middle class and lower class incomes for the first time in a generation, then the Trump voters were never convinced in the first place.
This idea is the biggest pipe dream to emerge since Hillary lost her election.
I appreciated this article clearly covering the questions of science here. The Republicans (and unfortunately Trump is solidly in the Republican mainstream on contraception and on opposition to science) will continue their villainy as long as they are in power. They are impervious to factual argument.
13
Please don't play down side effects, especially mood changes, and the increased likelihood of engagement in risky sex. Many women experience drastic mood changes and go on additional drugs for depression, anxiety, and other mental health issues because they don't realize that their birth control pill is literally driving them crazy. Moreover, most people I have ever known who have taken oral contraception are much more lax about using condoms to protect against STDs. The pandemic occurrence of HPV makes the link between increased oral contraceptive use and decreased use of additional protection quite obvious.
1
Can you document any of your claims with scientific studies?
5
"Obvious" doesn't actually mean "real". The numbers belie your assertions.
5
Your sources? Your statistics? The side effects you are scarily quoting are not in a high percentage of cases AT ALL. You are trolling.
15
Though these policies attack women's rights, many women of a conservative mindset support them. My experience with these women is that they separate themselves from the reality of what they're saying in an extremely unreflected way.It is only until their child becomes pregnant, takes drugs, etc. that realty hits.
24
Few remember that Dr. John Rock, scientist, infertility specialist, OB/GYN, devout Catholic, and father of five children, taught the rhythm method of contraception in his classes at Harvard Medical School, but later helped develop the birth control pill. He became a strong advocate for it because of his great compassion toward his patients. One of his most memorable patients was near-suicidal--she was the married mother of ten children under the age of six--every time she got pregnant (each year), she gave birth to twins. Dr. Rock later published a book, "The Time Has Come: A Catholic Doctor's Proposals to End the Battle over Birth Control," and tried hard to convince papal authorities of the humanitarian benefits of contraceptives other than the rhythm method.
You religious folk: God gave us reproductive organs to procreate and to enjoy sexual activity. S/He also gave us brains and hearts. Unwanted pregnancies cause anguish. Most abortions are obtained by women who are already mothers. It just makes sense to use our God-given brains to use contraceptives to reduce the need for abortion.
Some say women should just tell men to refrain from sexual intercourse. Yeah, right. Do you know how many wives have been raped by their husbands for trying to withhold sex? Contraception saves sanity, saves marriages, and saves women from needless abortions and babies they're unprepared to care for without public assistance. A decent society provides birth control to all who want it.
50
This is an excellent riposte to "EI"....whoever that is.
4
Forcing a girl or woman to carry a pregnancy she does not want is an act of terrorism.
29
14-year-old girls getting long-acting birth control? How can they aid and abet statutory rape by informing a partner in a consenting act (can they give consent to statutory rape?) that they have contraception? Why provide an “at risk” population medical protection for their committing a crime?
Now we have the issue of a 14-year-old bride: She would be supported in getting long-acting birth control at 14, so as to not get an unwanted pregnancy, yet there is a problem with her being in a marriage? https://nyti.ms/2mBrZHa Protect yourself from unwanted pregnancy, but you are too young to be married (did you finish your HW?).
Let’s table Comprehensive Immigration Reform until we figure out what we are doing to our children by saying they are too young to be married, that sex with them is criminal, yet we support and pay for their use of contraception as long as it is outside of marriage and that they would be a victim of rape if they consented.
1
Talk about circular reasoning!!! Defect in critical reasoning.
9
Statutory rape is when an adult has sex with a minor. 14 year olds who are having sex with others under 18 are not victims of statutory rape. So your objection is moot.
11
Not sure what your point is, but some 14 year olds need birth control pills for the hormonal control, not for actual pregnancy prevention. The issue of letting them marry at that age isn't really the point of this legislation.
5
Peer reviewed data does not sway trump and his stooges. They say what they want because their supporters do not "believe" the facts. Face it, we are a nation of ignorant people, who have little to no knowledge or interest in the scientific process. I say this from the perspective of a scientist who has spoken to many non-scientific people.
23
When I lived in Northern Virginia in the early 2000s there were at least 7 organizations in my county that fought contraception and abortion. They supported pregnant teens because they were saving the souls of the mothers and unborn babies for Christ. These groups were present at various community sponsored health events, Planned Parenthood was not invited.
8
This has Pence written all over it!
25
How many times do we discuss risky sexual behavior in relation to men's health?
26
Is Viagra still covered?
20
1) There was never a HHS mandate to cover Viagra.
2) Many insurers/companies do not cover Viagra.
3) So your comparison doesn't hold up.
1
But the coverage of viagra depends on the insurance company? But not the employer, right?
We must look like idiots to the rest of the civilized world when it comes to health care policies. We can't seem to decide if profit, religious belief, or quality of care is important. Thus we end up with totally irrational policies. Particularly when policy decisions about women's health are concerned. I'd love to see what would happen when women made decisions about men's health care.
37
Having once had a conversation on a stalled chairlift with a professor of public health policy from Australia - yes, to the rest of the world, we do look like idiots.
2
It's not about the Science, or even Money. It's about power, and control over Women. Keep them barefoot, pregnant and ignorant. That's not just a nasty old saying, that's the GOAL. Thanks, GOP.
53
Eliminate SNAP (food stamps) and starve them, too.
11
Thank you Phyliss, my exact thoughts. If it were about "side effects" then thousands of drugs on the market would be taken off. It's obvious what the goal is, and it is controlling women's bodies.
23
Remember, the GOP has always claimed to be the party of "family values." It seems that those are the family "values" they are referring to, because they certainly have not proposed paid maternity/paternity leave or subsidies for early daycare for those who must return to work when the baby is only a few weeks old. Or flexible scheduling. Or any other policy that makes it easier for a working parent to spend time with their children.
Trump the theocrat, another title to this president!
5
Liberal woman should be given free contraception. Help save the world.
3
This sounds disturbingly close the white supremacist ranting about denying white women birth control to increase the number of white people in the world. Slippery slope...
6
Trump despises science, just look at his position on global warming. This is strictly political payback for all those people who protect fetuses but despise human beings. The result: More unwanted children coming into a world with less and less future. Trump and his wives and mistresses clearly practice birth control, typical Grand Old Phony hypocrisy.
17
Given the hurricanes that coincided with his climate denial, he'd better beef up Head Start.
7
Joe Beckman---So true. Due to being homebound, being uprooted, and/or store closures, many women have been unable to get their scrips renewed. This will translate into additional unplanned pregnancies.
1
Aaron, you will not win an argument against ‘alternative facts’, designed to promote abstinence.
5
How can birth control possibly be correlated with “risky sexual behavior”?? I thought using protection was the definition of safer sex.
17
Why are we returning to pre-1960? We are in the 21st century for god's sake!
15
because that's where they want women.
2
No. We're returning to 2009. If your company covers birth control (and most do) you might have to pay a small co-pay.
Disgusting I know.
I cannot believe this is even a debate. We need a study to tell us that increased availability of long-term contraception will reduce unwanted pregnancy? And do we need a study to tell us that unwanted pregnancies disproportionately produce children who are not raised/parented/educated properly and who become the next generation's criminals and prison inmates? Let them have all the sex they want, just don't let that irresponsible behavior produce BABIES. Babies that society has to pay for and deal with on multiple fronts. Babies that will likely be abused or neglected because they are born to individuals unprepared and unwilling to shoulder the immense burdens of parenthood. Add to that the fact that this world has a huge overpopulation problem and my argument is why aren't you encouraging free and available long-term birth control to anyone who wants it?!
27
There is zero science behind this mandate. Access to contraception, especially LARC, reduces unplanned pregnancies and does not encourage "risky" sexual behavior. This is fact as pointed out by the author. The point of this ruling is the thin edge of the wedge. Once you have taken the first step and said it is acceptable to deny contraception based on "fait" or belief, so the opposite of science, you have opened the door for the next restriction. The goal of the Susan B. Anthony List, who are running the reproductive health rulings in the Trump administration, has always been to make birth control and abortion illegal. This new rule helps to chart that course. The Trump Administration does not care about the facts nor do they really care about reducing unplanned pregnancies or abortion. If they did IUDs would be free.
19
Get the gov't out of medical decisions, which should be between the patient and his/her doctor. But let's also realize that "he who calls the tune, pays the piper" -- an old-fashioned saying that can be roughly updated to mean "make your own choices, pay your own bills."
2
Except many women are on birth control for reasons other than contraceptive measures. Women don't choose to have PMDD, or irregular cycles, both of which can be helped tremendously from the correct dosage of hormonal birth control. In these cases it's not a matter of "make your own choices," it's "find the best medical solution for the biological circumstances that are beyond your own choices."
22
Why, when two people "make the choice" to have sex, is it only one of them that has to pay for contraception or take the risk of pregnancy? (My doctor is not usually part of that choice, by the way.) Why should the cost and the risk always be only on the woman? Men also benefit, by the way, with a society that has fewer unintended pregnancies. Your argument about individual responsibility would make sense only if the cost and the consequences were equally shared.
24
I would bet my next paycheck that married moms are the demographic having the most sex and using the most birth control. Think about it: I bet every parent you know has fewer than 5 kids. That doesn't happen by magic, folks. Yet, the media always reports on birth control in the context teens and "promiscuous" sex. That skewed reporting creates a skewed cultural narrative surrounding birth control, a narrative that certain "representatives" are happy to latch onto when justifying bad policy decisions. And, frankly, Congress should know better from personal experience. I don't see any of our Congresswomen (or our Congressmen's wives) popping out 12 kids. Again, it's not by magic: it's birth control and/or sterilization. I'd like to see a more practical, grounded discussion on this topic by both politicians and the media.
57
Exactly! Every argument I see talks about sluts and whores who can't keep their legs closed, hence birth control. WHAT ABOUT THE MARRIED FOLKS!? Honestly, family planning is for single and married individuals. It's literally for everyone.
20
Without birth control, women would have 8 to 13 children, just like my great grandparents did. This country will not stay ahead of the Chinese, Russians and Indians by minimizing the education and opportunity of half their population. They have only 1/3 the population and so they need all the good ideas they can find to keep with the 2 billion Indians and Chinese who are moving forward with education.
4
Of course no "scientific" arguments will sway Trump, Pence, et al, who care only about the support of religious conservatives, irrespective of the effects of reduced access to contraception. I wonder, though, whether Trump fans have given much thought to the implications of recognizing employers "religious freedom" to determine what insurers cover. Suppose I disapprove on religious grounds of smoking or drinking alcoholic beverages. Does that mean I as an employer can deny coverage for lung cancer treatment to smokers or treatment for cirrhosis to alcoholics? What if I oppose firearms on religious grounds and so deny coverage for gun accidents? Will those who champion the right of Christian conservative business owners to decide on their employees health care coverage also defend a Muslim who cites Sharia to deny coverage?
30
Ironically, Trump's recent curtailments on health insurance support of birth control to cater to the dubiously-Christian religious right may result in the increased use of abortifacients, particularly for poor women who can no longer afford birth control when not covered by insurance,
Women in such a predicament may choose the less expensive choice. In many cases, this might be the only choice they can afford, resulting in chemically induced abortion instead of contraception. The resulting increase in abortions would, however, be consistent with Republican views that health care choices are solely economic issues.
15
If you mean Plan B, it is not an abortifacient. I thought it was until I did some research into how it works. If a woman does become pregnant, Plan B prevents the egg from implanting in her uterus. This essentially renders her pregnancy a miscarriage. If a woman does not become prenant, nothing happens.
Stauch pro-life supporters may say that the egg was a life, and therefore, it was aborted. Perhaps: we do not know when life begins, thus, we do cannot say. I prefer to encourage my customers (I work in a retail pharmacy) when they show the responsibility for their actions, and are adult enough to know they are not prepared to raise a child.
I am pro-choice, yes, but I would prefer that every all pregnancy is wanted, or taken to term and adopted out to wonderful parents. The thing is, I understand that the individual has important choices to make, and they are her's alone. She should tell the father, but sometimes she doesn't. My brother and I were adopted by our parents, and we are a great family. Unfortunately, a lot of strange things happen. Rushed sex. Someone forgot to take their pills. No one brought the condoms. Someone was sexually assaulted. Plan B is an necessary piece of our contraception choice.
10
"Every health decision weighs benefits and harms, and birth control provides benefits beyond preventing pregnancies, including reduced rates of some cancers, regular cycles and reduced bleeding and menstrual cramps."
I am totally confused as to why this hasn't been a larger part of the conversation about birth control coverage. There are myriad uses for hormone regulation that have nothing to do with contraception, and for which birth control is the safest, simplest, and sometimes only option. A large proportion of women rely on "birth control" (we may need a broader term, to accurately name it) to manage these conditions. How can anyone justify refusing women access to treatment? Answer: most of the people in charge have never heard of things like amenorrhea, endometriosis, and dysmenorrhea, let alone have the organs to experience them at all.
http://www.aafp.org/afp/2010/0801/p288.html
https://www.guttmacher.org/news-release/2011/many-american-women-use-bir...
NYT, I would love to finally see an article about this issue, too.
20
Another use of birth control pills, although hardly earthshaking in importance, is the non-antibiotic related clearing of outbreaks of pimples/acne.
3
The article mentions the decline in teen births and from the link that follows, the rates between 1990-2014 peaked in 1991 and declined since - very sharply especially for black and Hispanic teenagers. That's Table 1.
https://www.hhs.gov/ash/oah/adolescent-development/reproductive-health-a...
The map below that table shows the states color-coded for rates of teenage (15-19) birthrates in 2014. I've pointed it out before, but the states with rates above the national average tend also to produce a lot of the sanctimonious lecturing on morality we get from folks like Pence and now-resigned Price.
Here are the states with teen birthrates higher than the national average, ranked from most 39.5 to just above national average of 24.2. These numbers are per 1,000 teen girls 15 to 19 in each state.
Arkansas, Oklahoma, Mississippi, New Mexico, Texas, West Virginia, Louisiana, Kentucky, Tennessee, Alabama, Wyoming, Arizona, Nevada, South Carolina, District of Columbia, Georgia, Indiana, Alaska, Kansas, Missouri, Montana, South Dakota, North Carolina, Ohio
Becoming a parent as a teen is a reliable path to poverty for parent and child.
The HHS link pasted above says: "About 77 percent of teen pregnancies are unplanned. In other words, they are unwanted or occurred “too soon,” according to a national survey of adolescents."
Good education and hope for jobs afterwards seems what's needed. Plus birth control.
12
Employers should be free to not cover contraceptives, and instead cover the cost of raising the children who result and all the societal harms that come from large numbers of children born to people who can't afford them. The second option costs 1,000x more. Companies get to pick.
26
So, you're discounting personal responsibility as the reason poorer classes of women have multiple children? This should remain an issue of personal choice, not the gov't's business or anyone else's. Frankly, I don't get why women are pushing to have employers bear the cost of birth control pills; the scenario will be women can engage promiscuously whenever and wherever they get the urge, and throw caution to the wind, while someone else gets to foot the bill.
1
OK, you realize that men are also participants in sex? In your scenario where are they? Aren't they are usually the ones engaging in "promiscuous sex", throwing caution to the wind, while the woman pays the price? Many of us who are female and using birth control are doing so in monogamous relationships. How does that fit into your narrative? If you are married but poor, it can be difficult to avoid unwanted pregnancy while still having sex.
1
I bet the companies love mammon more than their convenient interpretation of God, and few will drop contraceptive coverage. Why? Employers that reduce contraception coverage are likely to see their costs for health insurance RISE. Contraception saves insurance providers a lot of money because pregnancy is expensive and prevention is cheap. Insurance providers will look at their risk tables and increase premiums. Either the companies that cut contraception will be less profitable, or they will pass the cost on to their employees and become less attractive employers, or they will raise prices and become less competitive. Money will win and they will decide to instead change God slightly.
30
Nah, just fire pregnant ladies.
2
The increase in health costs doesn't end with the pregnancy and birth. There is another person to cover - for up to 29 years, I believe it is now.
And where do vaccines fall in this picture? Are we now medically at the whim of a politician who, claiming some religious criteria, can alter care to accommodate his beliefs? In the extreme if it were a Christian Scientist, would there be any medical care at all?
35
Recent studies have shown that generally a man is involved when a woman becomes pregnant.
Aside from that, if we're going to state that someone shouldn't pay for health coverage they don't need then we may as well throw out the whole idea of health insurance entirely. Pooling money to be used by others or ourselves when necessary is fundamental to how insurance works.
64
This article makes no mention of the more dangerous risks of hormonal contraceptives – namely life-threatening blood clots and increased risk of breast cancer. I met last year a 20-year old woman who nearly lost her arm from an arterial blood clot from a hormone-secreting IUD.
The article notes that rates of teenage sexual activity have declined along with unintended pregnancy. Has the author considered the possibility that the two trends are related? That a decrease in sexual activity leads to a decrease in unintended pregnancy?
It is good news that more teenagers are waking up to the dangers of premature sexual activity outside of marriage. Aside from undesired pregnancy, these risks include a wide variety of sexually transmitted diseases and exposure to sexual assault as well as emotional injury.
American society has been awash in contraceptives for over 50 years. Yet we still have millions of undesired pregnancies and out-of-wedlock births. Why? The answer lies in an entertainment and advertisement culture that relentlessly glorifies sexual promiscuity. All the contraceptives in the world are no match for these cultural forces.
The only form of risk-free contraception that works is abstinence. This is what pediatricians should be promoting to children, not contraceptives.
4
Teen pregnancy rates in the 1950's were much higher than those of today, and they didn't have nearly as much access to modern media as we do today. They also lacked contraceptives, which probably would have helped greatly.
23
Everything has risks - and I think studies show the riskiest option here would be abstinence only education. To quote one study
".. increasing emphasis on abstinence education is positively correlated with teenage pregnancy and birth rates. This trend remains significant after accounting for socioeconomic status, teen educational attainment, ethnic composition of the teen population, and availability of Medicaid waivers for family planning services in each state. These data show clearly that abstinence-only education as a state policy is ineffective in preventing teenage pregnancy and may actually be contributing to the high teenage pregnancy rates in the U.S. "
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3194801/
28
True, oral contraceptives are associated with significant health risks, including pulmonary embolism. However, the use of oral contraception is associated with a reduced risk of death since pregnancy and the postpartum period are associated with many lethal conditions including ectopic pregnancy, sepsis, placental abruption, postpartum hemorrhage and of course, pulmonary embolism.
33
It confuses me that the people who are most anti-abortion also tend to be anti-contraceptives, since making contraceptives less readily available would logically lead to more abortions.
84
This logic is lost on the evangelicals for whom this ruling is designed.
6
I have been confused by this as well and the only answer I see, whether conscious or not, is control and power over women mixed in with "sex is for procreation and not pleasure". How can it be otherwise? Women are not trusted to make medical decisions for themselves, decide if and when they want children or if they want to separate sex from reproduction.
8
I forget where I read it, but it makes perfect sense to me: People who say they are pro-life are not pro-life. They are pro-birth. Once that child is born, they don't care what happens to it. If they were really pro-life, like you said, they would support contraceptives. But then again, many of those who are anti-contraceptive don't understand how many of the options work.
6
How about this as a standard: any man who can get pregnant can have a say about birth control. Otherwise, please be quiet. Please. Forever.
130
Or seriously increase funding for male birth control, which is neglected because of a perceived lack of interest.
As suggested by several on here, the better option women could suggest might be abstinence. Then perhaps men might be interested in birth control coverage.
6
Sure...just as soon as you stop asking men for their tax dollars!
Until then though...
But I'll bet they still will supply Viagra, Cialis, et al. And if birth control is so terribly harmful, why not also regulate guns? They don't seem to be so healthy for people, either.
96
Right, but we don't get those for free. and that's what this is about. have you missed this?
2
All these drugs can be used to increase the same unwanted sexual behavior they seem to be concerned about.
And no comment period!!!!!!
Guns can be used to kill unwanted fetuses, the only life they care about, just like abortions, so why aren't they banning guns?
2
1) Guns are already regulated. But BTW Guns are actually mentioned in the Bill of Rights. Birth control is not.
2) There was no mandate by HHS to force companies to supply ED for free to any man who wanted them.
3) Many employers and insurance companies do not pay for ED drugs. Somehow men take this in stride and pay for such things when they need them. Horrible, I know.
So this administration believes the science and data they want to believe regarding eliminating birth control, but they don’t believe the science and data and clear evidence related to climate change? Makes perfect sense. *Eyeroll*
36
When are we going to change the paradigm and start procecuting men who cause unwanted pregnancy? With this current goverment's abysmal dumbness, let them experience their own logic!
24
So how do you resolve the problem of protecting the unborn - no abortions. When all you really want to do is bomb North Korea and kill millions. Either you're for protecting life or you're not, Donald.
13
While I applaud the writer for his basing his information on science, an administration that is vehemently opposed to science can't be won over. It's the same posture it has on climate change. And the underlying rationale, that contraception leads to promiscuity is a 19th Century Victorian rant. Young women should keep their legs crossed and come home in a group. It's the old myth about sin. Since sex is fun and young boys and girls with raging hormones are eager to get beyond mere masturbation and into something with human contact, lets press for abstinence. Hooey! A bunch of old men and menopausal women in Congress and statehouses who are no longer able to enjoy sexual activity are making our laws. Teach young people to care about their own bodies and make them aware of consequences such as STDs, but to even hint at their being consciously chaste is folly.
20
If you think menopausal and post menopausal women are unable to enjoy sex, boy are you missing out. Or are you doing a trump and reducing the age requirement for your potential partners in fun.
6
You are wrong, Mr. Manning. It's not the menopausal women in Congress who are trying to deny women birth control and abortion--most recently, it was a caucus of 13 Republican men. And as a post-menopausal woman, let me tell you that we are perfectly capable of enjoying sexual activity.
14
The author wrote that "[e]ffective, long-acting birth control can be expensive." From an economic perspective, why focus on long-acting methods (e.g., IUDs) rather than the pill. Planned Parenthood estimates the pill costs between $12-$50/mo. Just as an insurer, Medicare, or Medicaid may insist that you use a less expensive (but equally effective) treatment or generic medication, it isn't feasible to suggest that everyone is entitled to an IUD at no direct cost to the patient. Likewise, why are birth control medications placed in a special category above all other medications/treatments such that there is no co-pay or other out of pocket cost? You typically have a co-pay or deductible for cancer medications, surgery, etc. It defies a fundamental principle of insurance to have no direct cost of any sort. What actuarial basis supported this decision?
3
How about men being responsible for birth control? After all it is men who empregnante women!
How about you take the pill and free us women from all the worries of buying it, taking it, forgetting it etc.. Then come back with your comments. Because there wouldn't be any such discussion if it was culturally established that men should bear the burden of preventing unwanted pregnancy. This government is too patriarchal and backward to even see where the problem is!
21
"It defies a fundamental principle of insurance to have no direct cost of any sort."
Huh? It does? Why? How about the direct cost to me is my insurance premium that I pay and that my employer pays as a part of my employee benefits package. That costs thousands of dollars per year. I'm a young, healthy woman. I contribute SO much more than I take out. Effective contraception is dramatically less expensive than the cost to my insurer if I get pregnant, too.
"Likewise, why are birth control medications placed in a special category above all other medications/treatments such that there is no co-pay or other out of pocket cost?"
Well, here's what happened: The ACA required insurers to cover certain types of preventative care with no co-pay. Contraception was one of those things. This choice was made for public policy reasons: to ensure that women had minimal to no barriers to access, for the good of their health and also as a cost-saving measure. (See e.g., An IUD costs $1,000. The cost of an uncomplicated vaginal delivery is approx. 10-15k; a c-section can run you 30k +, a child in the NICU for 8 weeks will cost you hundreds of thousands of dollars. What's cheaper?) Where have you been all this time?
The focus is on long acting methods because in the long run they're cheaper and more effective. First, the pill only costs $10-$50 WITH insurance coverage. All pills are different. $600/year for pills is much more expensive than $1,000/5-10 years for an IUD.
28
Since you asked:
IUDs and other LARCs are the most effective contraceptives at preventing unplanned pregnancies because they eliminate user error, and therefore, while they are more expensive up-front, over their intended life spans they are also more cost-effective.
The ACA requires that certain preventive services, as determined by the non-partisan Institute Of Medicine, be provided at no out-of-pocket cost to the patient, arguing that prevention is better than cure. Contraceptives are included along with vaccines, colonoscopies, mammograms, etc.
https://www.kff.org/health-reform/fact-sheet/preventive-services-covered...
The answers are available to those willing to learn the facts about the law, and not be blinded by their ideology.
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"In a new rule about coverage of contraception, the Trump administration argues against the positives of birth control and highlights potential harms."
The new rule IS NOT about contraception or health care. It IS about reactionary politics & theology plus a large measure of misogyny. Trumpian, in other words...
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Exactly. Exhaustively trying to address the patently phony justifications offered by the Administration for this pandering move is a waste of time.
15
So when will we see employers be given the right to deny coverage for viagra, blood transfusions and psychiatric drugs to name just a few other things people have moral objections to? Why just the focus on contraceptives? Oh that's right, it mainly effects women.
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Sigh. Employers can and do deny coverage for viagra and other ED drugs. They did this before 2009. They do it today.
In nature the purpose of sexual intercourse is to make babies. It is hard to accept any scientist that supports going against nature for claimed scientific reasons.
The technology of contraception supports the destruction of the family by promoting sex outside of marriage as if it is a morally neutral choice that has no effect on stable child rearing and family economics. Abortion remains commonplace in spite of free contraceptives.
Richard Thaler of the University of Chicago Booth School of Business was awarded the Nobel prize for economics yesterday, in part for his study of overconfidence and bad choices. Perhaps contraceptives solve one problem while creating other problems closely intertwined with overconfidence and temptation.
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Mr. Devany,
I have to wonder if you are living in the same century as the rest of us. Families are anything but undermined by parents (single or married) who plan the arrivals of their children. This assures ample resources so that these babies can come into the world without needless hardship. A wanted baby is a happy baby. God's plan, if he exists, has nothing to do with it. People who are intelligent plan their lives to the extent that they can. Avoidable, unintended pregnancy belongs forever in the past. Increasing the difficulty of achieving this objective is criminally irresponsible. Religion has no place in making public policy at any time, but especially when it can seriously impede the well being of women and children. If you don't believe in contraception don't practice it. But make sure your mate agrees with you. Otherwise stay off that field.
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Actually sex feels good to all species. Otherwise why would male praying mantises knowingly go to their death during sex? If sex was just about reproduction there would be a lot fewer people on our planet.
7
I believe this article just knocked down what you are purporting, but carry on. Contraception does not destroy families, though the lack of it might. See what I did? Your arguments can be turned on their heads. Contraception does not promote sex outside of marriage either. It does, however, promote planned pregnancy. What's wrong with that?
21
Is it a woman's right to force her employer to pay for her path to risk-free sex? I struggle with this, since men's contraceptives are seldom covered and freedom of choice still exists.
I also believe if the Obama HHS had not ceded the moral high ground in this argument by demanding Free Plan B as well that this rollback would never have occurred.
My 2 cents.
WR
3
Risk-free sex? How so? Contraception deters pregnancy, not HIV, not HPV, nor any other sexually transmitted ill.
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Because it involves sex, it will remain controversial for some people. But, yes, it's a privacy right, because we believe it's up to a doctor and a patient to decide what preventive and other care to prescribe and take, subject to review by medical boards, etc. Vasectomy costs are a grey area; Medicaid and some insurance companies cover them supposedly.
More BC could probably be available OTC, but the most efficient methods still require professional consultation. Preventive care is currently mandatory and privileged (no co-pays) in medical insurance because of its economic and public health benefits.
13
This is an economic issue, not a human rights issue. There's nothing in this article that states women cannot purchase birth control on their own.
If you can't afford fancy birth control without insurance, use condoms. They are certainly cheaper than having a child and can be purchased in small affordable batches.
On a micro level, women should absolutely be requesting that their male sex partners contribute to the costs of their birth control. If they refuse to cough up some dough, stop having sex with them.
5
The fact that your boss can now dictate which particular medications your insurance company will pay for based on his personal MORAL/RELIGIOUS beliefs (as opposed to his economic considerations) is absolutely a human rights issue.
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I demand that I am able to purchase the health care I need using my health insurance, which is part of my compensation package. My employer has no right to tell me how I can spend my compensation.
Get it?
44
I think that's where people fear the rollback will go, but that's not currently what it entails. Also, insurance companies strongly favor BC for economic reasons, so bosses with such beliefs, real or feigned, may not be able to negotiate insurance plans for employees without BC.
Another solution might be universal coverage with multiple payors (evolving from current insurers); one or two of the payors could be opt-out payors for religious sects.
Germany has a multi-payor system that evolved mainly from the old craft guilds. It has elements of competition but also a system among the payors to even out the insurance risk structure so that no single payor can outperform the others by excluding lots of coverage, and the one that ends up with the poorest and sickest patients gets a subsidy (it's fairly byzantine and ranks no. 8 (above average) in terms of expenses for the 10-11 European systems that are typically included in studies).
3
True story: I went to dinner with a big company salesman. I guess he felt safe with us. He showed us photos of his wife and two kids and their backyard pool in Southern California. Then he confided his problem. His sister was an unwed mother who had 23 children. That's right 23. He said she kept trying to visit with the brood, (so they could swim) and it overwhelmed his wife and kids and freaked out his neighbors. It must have been a form of mental illness that kept making her try to get pregnant again.
3
Being able to control women’s reproductive choices is the ultimate prize for the GOP, and you could almost swear they are on a campaign to blame and punish women for “original sin.” As a sign at a recent demonstration against the administration’s efforts to limit access to contraception so succinctly put it :
“Keep your theology out of my biology!”
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The republican war on women continues.
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Generally a good analysis, and one that appeals to common sense as much as statistics.
One question though: the piece states: "The ending date of 2002, even though we have much more current data, is also strange. If we looked more recently, we’d see very different results. In 2011, the unintended pregnancy rate hit a 30-year low. "
The link cites the 2011 number as 2.8 million unintended pregnancies out of 6.1 million total. That's 46%, which is not "very different" from the 49% in 2002. Does this passage need some clarification?
7
This is a very concerning development but consistent with what we have seen from the Trump Administration. He has brought in people with extremist views and allowed them to use spurious "science" or alternative facts to make policy decisions at a real cost to people and our environment. We see the same pattern with contraceptives, environmental regulations, immigration, trade, and law enforcement.
We all have an obligation -- citizens, the media, elected officials, the judiciary -- to have the right fact based debate and challenge their conclusions to protect us all.
27
What is it about old white men wanting to control women's bodies? The most unconscionable factor about this new ruling restricting access to FDA approved contraceptives is that under-employed, low-income, and medically underserved women will be disproportionately affected by this policy. Women who have low-paying jobs and can't pay the cost of birth control because their employers decided not to include it in their insurance policies.
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The men who want to control women's bodies do so because women who cannot control their reproductive lives cannot pursue educational and employment opportunities, leaving them open to men. These are men who believe they cannot achieve on their own merits, and on a level playing field. They try to make up for their own weakness not by improving their own skills, but by ensuring others have fewer rights and opportunities. That is one of many reasons why we need the Equal Rights Amendment.
43
@Susan: And the resulting pregnancies will make it even harder for them to make ends meet, especially if they lose the job due to absences caused by pregnancy and later by child illness, etc.
15
Can you imagine how much easier it must have been to make a living and make your way in the world when you didn't have to compete against minorities and women!? What a leg up! Just cut most of your competition out of the game.
Even better if you get to claim ownership over the labor of women and minorities and refuse to compensate them. Ahhhhhh bliss. No wonder they don't want to give up control.
2
Trump and his followers are pushing women's right back towards a past that condemned women to being second class citizens. From the fight for voting rights to the fight for workplace equality, women have gradually seen their pay equity rights, human decency rights and the ability to function in the work place as opposed to being baby producing machines become eroded. These are not just mere words.
Reading the news article on cancelled birth control coverage is horrifying. Do we say that we give in and we will let men control our bodies? How can we stop the Trumpian dystopia and the GOP inspired misogyny? Saudi Arabia is an example of what can happen to women. Girls can be trained from birth to believe they are second class citizens. Women are fifty percent of the global population. Statistics have proven that in every society that accepted women as equal to men, society benefited with increased productivity, economic success and peace. It seems that protesting doesn't work. Contacting your political representative doesn't work.
Perhaps it will have to go back to the bedroom, where women simply withhold sex until there is change, just like in the Greek play Lysistrata, where women withheld sex in order to end a war.
42
Young women should be trained from birth to believe that they are special and should never take 2nd or 3rd class in education or mates. Protect your body for what you want, don't share it with any guy who buys you a hamburger and a Coke. You deserve better and best.
This is clearly a bone tossed to the Religious Right.
I've never quite gotten their opposition to birth control. Religious conservatives are opposed to abortion on moral grounds. Fair enough, I'm opposed to abortion on moral grounds too though I also believe that women are capable of making the profoundly moral decision to terminate a pregnancy and that it should be legal and readily available in the first months of pregnancy for those who need it. I suppose it has something to do with putting the sexual revolution genie back in the bottle and forcing "responsibility" on young women--never of course on young men.
What it will do lead to is more unwanted pregnancies, more abortions and more children on welfare which is something that all conservatives, both of the social and economic variety should want to avoid at all cost..
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Please, please, please stop using the word "free" in regards to covered contraception. It is not free -- it is part of the employee's duly earned compensation.
And, given that most employees are now required to fund at least part of their employer "provided" health insurance (which is really just a component of salary), why does the employer get the deciding vote in regards to what is covered? What's next? Will employers tell us which brands are acceptable to buy at the grocery store since they "provided" our paychecks?
This whole controversy has little or nothing to do with "religious freedom." It has far more to do with employers amassing and exerting power over their employees. https://www.vox.com/the-big-idea/2017/7/17/15973478/bosses-dictators-wor...
140
Well, suppose they give money instead. Once you are paid in cash, you can buy any legal product you want, and your employer will never know - or care. The cash economy resolves many contentious issues.
3
This controversy has everything to do with "religious freedom:" the religious freedom of the employees who have a right not to be subject to outrageous coercive religious practices of their employers.
No one is making any employer use contraception. The Obama administration, instead of enforcing the law as it should against institutions citing religion as an excuse to discriminate against their female employees on the basis of religion, instead jumped through hoops to allow the Little Sisters not to pay part of the compensation owed their employees by simply signing a paper. They refused to do even this, stating it was too much of a burden.
There is nothing in the Constitution that states religious freedom only applies to employers or that one citizen has the right to force another to adhere to religious practices that they do not agree with or even adverse to their conscience.
8
It has to do with employers saving money. Any offspring will not be provided for by them.
Science does not interest the GOP - witness their stand on teaching evolution in school.
Let's be honest, the GOP really does not care about abortion - if they did, they would encourage the use of contraceptives (and would also want to do more for the babies after they are born). The GOP cares about imposing their sexual morality on others, in particular on women.
77
It's not the sexuality of men. Women shouldn't have sex so that our husbands can control us. Don't hold your breath waiting for child support payments.
2
All science is doubtful. "Scientific" arguments in favor of birth control access are just as doubtful as those against.
In a decent and well.ordered society, refraining from sexual intercourse is a readily accessible form of birth control.
2
While all science should be subject to scrutiny, the quantity and quality of studies showing that birth control is beneficial far outweighs the science that says it is detrimental.
Plus, we don't live in a "decent and well-ordered" society - that is a subjective moral definition. People should be free to live the lives they choose.
35
Humans are sexual beings. We engage in sexual activity not only for procreation but for pleasure. Medical science has made advances, in the form of contraception, permitting women to enjoy sexual activity without the anxiety associated with the possibility of pregnancy. Science has provided us with a number of other items relating to our health and well bering--glasses, dentures, heart valves, prostheses to replace broken limbs. And Viagra to assist men with the inability to achieve an erection. So to maintain a "decent and well-ordered society" we should forgo these items as well?
17
Refraining from sex is only a solution in an imaginary society, and not too many of us want to imagine that.
23
Many medical conditions require the use of contraceptive pills. The catholic church, conservatives and the Grand Old Phonies are in denial on that.
They are also in denial about all children being wanted children. Many people do not view children as a gift from God but as another mouth to feed and they resent it and resent it and resent it. Taking away the ACA and all other social services to favor some billionaire somewhere doesn't make an unwanted child any easier to bear.
Taking away medical care, and abortion, even in circumstances where it will cost a woman her life to bear a child and make her existing children orphans is stunningly shortsighted. This idea, that we protect the fetus and only the fetus at all costs including over the lives of the currently living man woman and child/children, even when and especially when the fetus is not viable, is simply ridiculous, dangerously ridiculous. But it certainly let's women know that they are just broodmares.
82
And force woman into the unwanted slavery of carrying and laboring to birth an unwanted child, whether from rape, incest or otherwise, and risking her life and health to do so.
8
These anti-women promoters are woefully misinformed. When will insurance coverage be denied for ED? I guess erections are more valuable than unwanted children, or disabled, afflicted women.
64
ED medications are almost never covered on private insurance for the under 64 crowd. Part D plans are not required to cover it either.
4
Actually I find that most ED medicine is covered, just not for the amount most men want. Example, most insurance cover for 4 to 5 doses/pills per month, not the 30 doses/pills men think they need!
11
It is NOT TRUE that most insurance pays for ED drugs -- and anyways -- ED drugs are NOT an aphrodisiac and will not give "super sex powers" to healthy men without a medical problem.
Medicare, Medicaid, most private insurance DO NOT PAY for Viagra or Cialis.
Most men who want this, pay for it out of pocket.
1
I wonder about the rule of coverage for Viagra.
21
Was there a mandate that companies had to cover Viagra and provide it without co-pays?
Interesting analysis for Times readers. Too bad the administration cares not for an honest asessment of evidence.
22
Good thing they let the CHIP benefits expire at the same time. The GOP vampires war on women and children is winning - look for more deaths in childbirth, more sick kids, and more unintended pregnancies. This is the world the GOP wants.
Very strange people.
102
Yes, this is exactly the world the GOP wants. It's a feature, not a bug. More poor, uneducated and powerless women and kids to keep the slavery-wage workforce pipeline for the business owners going. Or the school-to-prison pipeline to benefit the private prison owners. All good things!
2
"Every dollar of public funding invested in family planning saves taxpayers at least $3.74 in pregnancy-related costs." I don't know how it would be estimated, but every dollar invested in family planning also saves thousands of dollars in environmental, educational, and numerous other costs. The first thing Trump did as president was to decrease world-wide contraception funding. Population is still an issue.
77
Luckily insurance companies employ actuaries who do understand that paying for contraceptives is the cheaper alternative. So I think the relatively small number of employers who will opt out of covering contraceptives is probably correct. That said, this new rule is deplorable and highlights the problem with health care insurance being largely employer provided in the US.
I am more concerned about the many women in states who did not opt for Medicaid expansion and who are in the income gap between pre-existing Medicaid and the ACA subsidies. Many of them have no health care insurance at all. For many of those women that means no access to reliable contraceptives.
64
Sad to see that a major Federal Agency has been taken over by anti-science zealots bent on punishing women. Those affected may either bear 100% of the financial burden of paying for over-priced contraception or face the life changing struggles of unwanted pregnancies, too often without the support of the father.
Its hard to understand the agenda of religious organizations in particular who are anti-science, anti-environment, anti-gay, anti-health and anti-women. These tendencies would appear to be driven more by spite, anger and wrath than love and compassion.
If so, they have found their perfect President. And he will never cease in feeding the fury.
116