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Blunt, Rubio, And The Madness of Employer-Based Health Care

I'm blinking in astonishment at the vote breakdown on the motion to table the Blunt-Rubio amendment allowing any "sponsor, issuer, or other entity" involved in providing health insurance--not just the Catholic Church--to eliminate coverage for contraceptives  if doing so conflicts with that sponsor's, issuer's, or other entitity's "religious beliefs or moral convictions." In the name of religious freedom, Sens. Roy Blunt and Marco Rubio tried to give bosses and insurance companies the freedom to impose their own religious or moral beliefs on their employees by withholding coverage for contraception. Not abortion, mind you. Contraception. And not for minors (minors don't typically obtain their own health insurance) but for adults; men and women over--in most instances, well over--the age of 18. Quite a lot of these men and women are married and want to use contraception when having sex with their very own husbands and wives.

(And incidentally, since the amendment doesn't specify that the potentially offending coverage is for contraception, your boss could just as easily decide--if I'm reading this language right-- that his religious beliefs didn't allow for his employees to receive coverage for an appendectomy.)

A Senate motion to table this bill only narrowly prevailed, 51-48.

Every Republican in the U.S. Senate save one voted against the motion (that is, effectively voted in favor of the bill). The exception was Sen. Olympia Snowe, R-ME, who was so annoyed by the pressure she was placed under to vote with her fellow Republicans that she decided not to run for re-election. Three conservative Democrats (Ben Nelson, Joe Manchin, and Bob Casey) voted against the motion too. Presidential candidate Mitt Romney, characteristically, flip-flopped on the issue, initially casting his lot with the position later taken by the Democrats and Snowe, then hastily switching over to the position later taken by the Republicans, Nelson, Manchin, and Casey.

I leave to my TNR colleagues Jon Cohn and Alec MacGillis the likely political harm Republicans have brought on themselves with this anti-fornication vote. I merely observe that procreation-free screwing is awfully popular. (I'm rather fond of it myself.) Fully 63 percent of all Americans, 73 percent of all women of childbearing age, 62 percent of independents, 60 percent of Catholics, and even 42 percent of Republicans want the federal government to require private health insurers to cover birth control (as provided under the supposedly unpopular Obamacare), according to a new poll from the Kaiser Family Foundation.

The narrowness of this Senate vote leaves me regretting that, even after Obamacare takes full effect, the United States is still going to provide health insurance coverage through the very clumsy mechanism of employment. Not only is it none of my employer's business whether I should be covered for contraception; it's none of my employer's business that I should be covered for anything at all. Here at the New Republic, I get paid to write blog posts and TRB columns. I don't get paid to fulfill the magazine owners' collective vision of how much or how little health insurance I should get. Society has a collective interest in setting certain parameters for what a decent health insurance policy should provide. But my employer doesn't, particularly. For one thing, it isn't TNR's area of expertise! Nor does it make sense that I get X amount of health insurance working for TNR but would get Y amount of health insurance if I worked for the Nation and Z amount of health insurance if I worked for the Atlantic or Harper's. People working at all these magazines should be offered the same amount of health insurance, and the entity doing the offering shouldn't be their bosses. It should be--shhhhhh!--their government.

Some might argue that all this would be worse if we had single-payer, because then Blunt and Rubio would be sponsoring legislation to deny contraceptive coverage to everybody. My answer to that is: I'd like to see them try. The Senate vote would be 98 to 2.

What's ironic about this debate is that employers don't really pay for health insurance, or indeed any benefits, at all. As any economist will tell you, the value of any employment benefit is, over time, taken out of what would otherwise be employee wages. Employers pass through the cost of health insurance, like they pass through the cost of anything else, by paying employees a bit less. (The only reason employees have consented to this arrangement until now is that buying health insurance as an individual is much more expensive than buying it as part of a group.) So the Blunt-Rubio construct that the Catholic Church, or your Holy Roller boss, shouldn't be forced to subsidize contraception against their beliefs is based on a false assumption. Ain't nobody subsidizing your health insurance but you. Or rather, once Obamacare takes effect, you and the federal government. That's true even without the Obama administration's clever health-insurance workaround with the Catholic Church. It would be true even if the Catholic Church were compelled to provide insurance coverage for abortion. It would be true if the Catholic Church were compelled to provide health insurance coverage for conversion to Zoroastrianism. The Catholic Church wouldn't pay. You'd pay. One powerful reason to hope that the U.S. someday shifts over to single payer is that all confusion on this point will finally be resolved.