The Costs of Contraception
A great deal of public discussion has been sparked by the recent determination of the Department of Health and Human Services that it would, under the legal authority of the new health care law, require health insurance plans to cover the costs of hormonal contraception. Much of that discussion has focused on the nature and importance of religious freedom, since the directives would require some institutions, such as Catholic hospitals and universities, to provide health insurance coverage for things that are contrary to Catholic moral teaching. To a lesser extent, the HHS regulations have provoked some renewed discussion—at least among Catholics, but perhaps more generally among religious conservatives—about the morality of contraception itself, a topic that had seemed closed as a topic of genuine inquiry for the last generation.
The HHS directives should also give rise to another discussion, one that so far has not been undertaken: a discussion not of the legality of the mandates, nor of the morality of contraception, but of the physical costs of contraception, of the negative consequences it may have for the health and well-being of the women who use it. This aspect of the question has been all but totally ignored. For their part, the liberal partisans of the HHS mandates speak as if hormonal contraception is simply an unmitigated good, a clean gain, for women. Indeed, their argument suggests that such contraception is so unequivocally good that there can be no reasonable argument about the propriety of mandating its coverage as a health care benefit.
This assumption deserves to be challenged because it is untrue. That is, hormonal contraception carries certain physical costs in addition to the benefits touted by its proponents. Unless these costs are frankly acknowledged, American women will be in no position to make an informed choice about whether or not to use contraception. Yet presumably Americans of all ideological persuasions could agree that women should be in a position to choose or reject contraception based upon full knowledge of its potential physical consequences.
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