The Birth Control Mandate and Gender Equality
The government states -- see also page 25 here -- that "gender equality" is one reason it is requiring employers to provide insurance that includes contraception with no copay. The basic idea is straightforward: Only women take birth-control pills; therefore women are footing the bill for extra expenses simply because they're women, and the government should step in. Countless pundits have similarly advanced the case that it's "unfair" for women to have to pay for birth control.
It's certainly true that only women take birth-control pills -- and that, as the government points out, overall health-care expenses are considerably higher for women. But it's less obvious why the expenses associated with birth control should be considered in the context of health care. Birth control is "health care" in the sense of coming from a doctor, but it's not health care in the sense of being designed to detect, prevent, or address some sort of ailment. Pregnancy is not a disease, and sex is something people may choose to engage in or not; birth-control pills are merely a product couples use so that they can have sex without becoming pregnant.
Arguably, for the purposes of "gender equality," the expenses of birth control are best considered in the context of those couples' relationships. Are men really free-riding on the birth-control expenditures of women?
Overall, there are three types of women who might want to use birth control: married women, women in sexual non-married relationships, and women who are single but sexually active. In none of these cases is the evidence overwhelming that women are being treated unfairly relative to men.
In the case of married women, the woman using birth control almost always shares a bank account with the man involved, or at least has come to some sort of detailed arrangement with him about which party pays for what. In fact, not only do married men share in the cost of birth control, but they also typically share in the overall higher cost of their wives' health care.
Similarly, women in sexual relationships have every opportunity to speak to their partners about finances -- instead of splitting every single dating-related expense down the middle, some couples may have arrangements that are unfair to either the man or the woman, but it's not clear why it serves the interest of "gender equality" for the government to step in when it comes to birth control but not other expenses.
What we are left with, then, are women who are having sex with men but don't feel comfortable talking to them about finances. Some conservatives might say this is not a government-mandate-caliber problem. But even these kinds of sexual encounters come with various kinds of non-gender-neutral expenses besides birth control. Men often pay for meals and drinks; women usually spend more time and money preparing to go out. Since the pill doesn't address STDs, there's also the question of who pays for condoms. Again, why are we singling out birth-control pills, available for $9 at Walmart, as the expense to gender-equalize?
The government makes more roundabout arguments, too: For example, without an insurance plan that fully covers birth control, some women might choose to go without it but keep having sex, placing themselves "at a competitive disadvantage in the workforce due to their inability to decide for themselves if and when to bear children." It's a clever argument, if you don't mind recasting grossly irresponsible behavior as gender-bias victimhood.
There are all sorts of reasons we might make birth control more accessible, and all sorts of debates we can have about forcing employers to include it in health plans. But "gender equality" is a bit of a stretch.
Robert VerBruggen is editor of RealClearPolicy. Twitter: @RAVerBruggen