Politically, the great contraception debate appears to have been a wash.
Republicans saw their message on religious liberty enveloped by the crude misogyny of radio host Rush Limbaugh. Democrats, anticipating a polling boost from outraged female voters, appear to have experienced nothing of the sort. Instead, in a Bloomberg News poll, three-quarters of respondents, including the majority of women, said the issue has no place in the debate.
Politics, however, is not all there is to political debates, even in Washington. The proximate cause of the drama was the Obama administration’s recent decision to require health insurers to provide free access to contraception for employees of religiously affiliated institutions, such as hospitals and colleges, that oppose contraception.
That move was itself a retreat -- an appropriate one -- from the administration’s initial position, which would have required religious institutions themselves to ensure access to birth control services and supplies. The distinction is subtle, but it was enough to soothe the concerns of many Catholic social organizations, if not the U.S. Conference of Catholic Bishops.
The Catholic Church, of course, has every right to oppose contraception and insist that its followers do likewise (although, according to polls, most U.S. Catholics don’t). But on both health and economic grounds, the federal government’s stake in the issue is considerable.
Using family planning to space out births improves both maternal and child health, including a reduction in low-birth-weight infants. It reduces unintended pregnancies, which are concentrated among teens, the poor and the unmarried. The children of such pregnancies have lower educational attainment and are less likely to graduate from college. They also have lower levels of labor-force participation and are more likely to be unmarried themselves.
The Brookings Institution estimates that taxpayers spend $12 billion annually on medical care for women with unintended pregnancies and their infants, and that expanding subsidies for family planning would save more than $4 for every $1 spent. Yet the economic impact of contraception is probably far broader than government expenditures.
In their 2002 study of the influence of oral contraceptives on women’s careers and marriages, economists Claudia Goldin and Lawrence F. Katz wrote that the advent of the pill in the 1960s made it easier for women to delay marriage, extend their educations and invest in careers. By “indirectly lowering the cost of career investment,” the pill helped start four decades of increased labor-force participation by women and a drastic narrowing of the gender gap in pay.
Contraception provides powerful benefits in another realm, one that we’d expect to be especially attractive to social conservatives. According to the Guttmacher Institute, more than 40 percent of unintended pregnancies are aborted. Although Americans differ in their opinions about the morality of abortion, there is broad consensus that fewer abortions are preferable to more. Abortion rates in Central Asia and Eastern Europe declined in the 1990s as the use of modern contraceptives increased. In the U.S., contraception use among teens is credited with a recent decline in teen pregnancy.
Unfortunately, conservatives in several states have seized the opportunity to inflame the controversy. The Arizona Senate is considering a bill, already passed by the state House, to give businesses the option to exclude contraceptives from health insurance coverage. In Texas, state legislators have joined Governor Rick Perry in working to defund and delegitimize family planning clinics associated with Planned Parenthood.
The federal government is right to encourage access to contraception. No church is required to dispense it; no congregant is required to use it simply because health insurance policies cover it. (The majority of private insurers covered birth control services and supplies before the Obama administration’s decision.) At this point contraception’s role in American culture and public health is firmly established. Why turn it into a political pill?
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