The Problem With the 'Accommodation'

The Problem With the 'Accommodation'

Recently, Supreme Court justice Sonia Sotomayor pushed the pause button on the administration's employer birth-control mandate -- at least for the employers that are party to the Little Sisters case. The details of the case are rather complicated, but at the heart of it is the "accommodation" the administration has offered to certain religious employers.

The arrangement goes like this: These employers won't have to pay for contraception through insurance plans. In fact, they'll sign a piece of paper saying they don't want to provide the coverage. Instead, the plans purchased by these employers will provide contraception free of charge. This can be done because -- at least in some studies -- expanding birth-control coverage can save insurers money through reduced costs for things like births and abortions.

To a lot of us, this is ludicrous on its face. The employer is still providing a plan, the plan is still covering contraceptives, and no one is spending a different amount of money than they otherwise would have. What exactly is the moral difference?

But here's a point that I haven't seen before: The administration's moral argument contradicts its economic argument.

The way insurance works is that in exchange for a certain payment X, an insurance company agrees to provide a bundle of services Y. Morally, the administration wants to break this into X1 and Y1 (the services except birth control) and X2 and Y2 (birth control). Thanks to the barrier in between, the employer can contribute to X1 without being morally involved in Y2.

But economically, the administration says the value of X2 is zero -- because providing service Y2 saves money. Where do those savings show up? Why, across that barrier, back in Y1. So the administration wants employers to see these as two separate bundles for moral purposes -- but it wants insurers to see them as a single bundle for economic purposes. Given that insurance is fundamentally an economic arrangement and any moral consequences must flow from there, I think that gap is hard to justify.

In one sentence: Birth control can save an insurer money only if it's functionally a part of a bigger plan paid for by an employer.

Robert VerBruggen is editor of RealClearPolicy. Twitter: @RAVerBruggen

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