Mormons & Birth Control

Joanna Brooks recently asked the question, why don’t LDS-owned health insurance companies provide coverage for birth control? I was on DMBA via BYU for my final two years of college (after I got married and had to get off Daddy’s insurance), and I found it pretty darned annoying that my birth control pills weren’t covered because they were “cosmetic” medicine. My pills had been prescribed by a dermatologist to deal with acne before I was ever sexually active, and I would make the case that combating out-of-control adult acne is more than just “cosmetic,” but DMBA disagreed with me.
I don’t buy that this is a cost-saving measure. I don’t know what they run for now, but in 2003, cheap birth control pills cost $240 – $360 a year. Installation of an IUD cost $300-$500 plus doctor’s visit to put it in and then you’re set for five years. Prenatal care plus a baby’s delivery could easily cost $20,000-$30,000—and that’s if everything goes smoothly.
I think that the policy is theological. No, it is not against current LDS policy to use non-permanent birth control—but it has always been LDS teaching that couples should have children, and that they should have as many children as they can manage. The take-home point that I got from DMBA’s policy was, “Sure, you can put off having children if you want, but don’t expect the church to help you with that.”
It wasn’t so long ago that LDS leaders were teaching against birth control. In fact, some of it is still in official LDS student manuals. I think the generation that looks down on couples who use birth control is still alive and well and having some influence on the church.
That’s my opinion. What’s yours?

Comments

Mormons & Birth Control — 8 Comments

  1. Yup.
    My dad is one of them. But in his case it was more a worry that we would put off kids in favor of finishing graduate degrees, or buying a new car, or being financially stable, or whatever else. Once that proved not to be the case and we had a child withing two years of marriage, then another two years later, I think he pretty-much didn’t care anymore and left it as “our own business.”
    But I think it is true enough that people delay having families a bit longer than I’m entirely comfortable with these days.
  2. I think it’s shortsighted of insurance companies not to cover contraception, but even so it is very common for health insurance not to cover prescriptions that aren’t being used to treat a disease or medical condition. So without having more information, I’d be reluctant to automatically assume that the reason for the exclusion is theological — it may just be that those in charge of such things were following industry standards. It has been only within the past 10 years or so that some states have required insurers to cover contraception (not necessarily free, but often with the same type of copay as for medicine).
    A summary of state laws can be found here.
    As I recall, the insurance we’ve had has covered sterilization (male or female) but not temporary means of contraception, and not sterilization reversals. I suppose part of the issue is that the insurance companies figured that people who really wanted contraception would get it somehow, so why should they foot the bill.
  3. Hi Jack!
    My opinion is that not including birth control drugs is shortsighted and foolish. My further opinion is that an insurance company that finds itself charging single young men for maternity care benefits while simultaneously denying coverage for contraceptives needs to have its trustees and actuaries slapped. As you more eloquently have pointed out.
    A 10 year IUD, by the way, is more like $1500, but that’s a billing amount. I’m sure the Blue Crosses and Humanas of the world weasel that down to $900 before ultimately paying $300. After they take your $600 monthly premium. Health care funding in the U.S. is seriously messed up. This latest teapot tempest about contraceptives and Catholics (and LDS, apparently) is just one small single facet.
  5. Who are these people who don’t use contraception and where are their kids?
    The idea that education should not get in the way of child bearing boggles my mind.
  6. Rob, the reason why insurance companies charge men for maternity coverage (actually, it’s bundled into the base rate, not as an option nor a separate line item) is because federal law (95-555, if I remember correctly, it was in the 1980′s), FORBIDS insurance companies from charging women MORE for maternity coverage.
    “Well-baby care” had to be covered as “any other accident or illness”, according to 95-555.
    (Previous to 95-555, if you didn’t have maternity coverage, you didn’t get “well-baby” care paid for, but you DID get coverage for any medical situation of a non-healthy newborn that went beyond normal well-baby care, if you had “family” or “children” coverage on your policy.)
    The law essentially disallowed maternity coverage as an option, requiring all insurance companies to _include_ it in the base coverage of all health insurance plans, hence it had to be in the base premium (price) of all health insurance plans.
    IE, if you’re going to cover maternity costs as you do a broken leg, then you have charge premiums like you do for a broken leg, as in everyone could get a broken leg. The insurance companies did not (and do not, as far as I know) have an option to do it any other way.
    By law, the premiums could not be focused on fertile women of child-bearing age. The premiums (built into the base rate) had to be spread among _all_ women (even post-menopausal, and those with their tubes tied) and _all_ men.
    I’m sure it’s been modified since then, but that’s the origin, which, at its base, is probably still in effect.
    Jack (and all), lets be careful to keep the distinction between contraceptive drugs for birth-control and contraceptive drugs for medical reasons.
    All insurance companies cover contraceptive drugs (the two are estrogen and progestin, almost always taken in combination) for _medical reasons_.
    If you had had an ovary problem that required estrogen/progestin, I’m sure it would have been covered. (The case of Miss Fluke’s friend losing an ovary was either fabricated, or a big snafu, as Catholic-owned/run businesses do in fact pay for estrogen/progestin when it is prescribed for medical reasons.)
    In your case, the fact that it was for _acne_ made it a _cosmetic_ treatment, and not a “medically necessary” thing. Apparently, acne treatments were/are not covered under DMBA.
    If it was severe enough, and if your dermatologist or primary care physician had responded that the severity of the acne was causing secondary infections or the like, it would have raised the urgency to “medically necessary.”
    Miss Fluke’s testimony, and most all the analysis of it in the media and by the pundits, has been very misleading in that it conflates the coverage of birth-control with the coverage of the same medicines that are prescribed for medically-necessary reasons.
    Coverage of estrogen/progestin for medically-necessary reasons, as prescribed by a doctor, has never been an issue, because no insurance company (nor self-insured entity) has denied such coverage.
    I haven’t listened or read Miss Fluke’s entire testimony, so maybe she did make the distinction, but the news reports and pundits have not.
  7. In your case, the fact that it was for _acne_ made it a _cosmetic_ treatment, and not a “medically necessary” thing.
    You see, I disagree. There’s nothing natural about acne; it isn’t what the human skin is supposed to look like. And not wanting nasty sores on your body (in any place) is absolutely a medical thing. It can also be incredibly damaging to mental health and self-esteem. It’s a medical condition every bit as much as psoriasis and eczema are. Birth control to deal with acne should absolutely be covered by insurance companies.
    (BTW, DMBA covered one of the acne creams that had been prescribed for me, so they were willing to treat acne. They didn’t consider it a “cosmetic” condition. They just weren’t willing to treat it with birth control. But I may be remembering wrong.)
    However, as I’ve thought about the Sandra Fluke debate, I’ve come down on the side of thinking that insurance companies should not be required to cover elective birth control. The idea is really attractive to me, because I would love to insure that my method of birth control is paid for by others for the rest of my life, and I actually think that Sandra Fluke is very well-spoken and persuasive, but I can’t agree with it for one simple reason: because sex is elective. It isn’t a necessity. If someone really cannot afford their preferred method of birth control, then they can simply not have sex. Sex is elective and using birth control during sex is elective, and I don’t think insurance companies should have to pay for elective medicine like that.
  8. Jack, you bring up the varying degrees of acne. Fortunately, my teenage acne was treatable with over-the-counter Stridex pads and Clearsil cream. It was just some random pimples and redness, and didn’t affect my self-esteem. But I knew I was lucky, as many of my peers had it much worse than I, and some for many more years than I did.
    You do bring up a good point in that if DMBA covered the acne cream for you, that’s evidence that they deemed your case a covered condition. And therefore they should have also covered whatever “usual and customary” treatments that the doctor deemed appropriate, including estrogen/progestin.
    At the heart of the Fluke/BC matter, I think is the current administration’s payoff to Big Pharma. From what I’ve read, the BC mandate has no cost containment, it’s whatever brands, whatever methods, whatever cost, that the consumer wants, with no deductible and no co-pay. With no deductible and no co-pay, and no incentive to get the generic, the nature of most people is then to go with the Cadillac brand $90/month pills from CVS/Walgreens, instead of the $9/month generics of the same formulation from Walmart, or $15/month from Planned Parenthood. Or even perhaps to the $1200- $1500/year implantables.
    One could even go the route of “triple redundancy” of using generic BC pills, plus buying name-brand condoms in 36-packs ($.75/each, even less for generics), plus spermacides ($1.00/use or less in bulk/generic) and still come in at under $500/year, even if they were having sex every other day.
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