A blog of politics, law, religion, and the tricky spots where they collide.

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“In August, the administration announced new rules requiring all new insurance plans to cover birth control and emergency contraception by 2013. At an early October fundraiser in St. Louis, President Obama himself hailed the rule. And when President Obama appeared before the U.N. in September, the administration touted the contraception rule as an example of America’s commitment to women. So when Carney says “this decision has not yet been made,” he’s wrong. It has been made—and by reopening it, President Obama is succumbing to pressure from anti-choice groups.

Even worse, Carney says President Obama is trying to “strike the right balance between expanding coverage of preventive services and respecting religious beliefs” without acknowledging the fact that the rules announced in August already included an exemption for churches.”

White House says Obama considering rolling back mandatory insurance coverage of contraception

This issue is not that simple.1

First, let’s get some facts straight. The rule issued previously was an interim rule, effective August 1, 2011. Public comments on the interim rule were accepted through September 30, 2011. The whole point of issuing an interim rule with request for comment is that you read the comments, and consider whether or not to amend the rule. The real scandal would be if the Obama administration didn’t consider the comments it solicited.

Second, I think it’s misleading to suggest that an exemption for churches is enough to satisfy all concerns about religious beliefs. Religious organizations also operate hospitals, schools, universities, etc.. That’s what the Catholic church is concerned about..

The Catholic church opposes contraception in pretty much all cases. While I disagree with them on this—I can’t deny that they’re sincere about it. We have a history of protecting religious beliefs from undue governmental interference. It’s part of that separation of church and state thing enshrined in the first amendment. And that’s where the issue gets messy.

Co-pay free access to contraception is extremely important for a whole slew of important societal ends. (Because I’d be preaching to the choir on this one, I won’t reiterate all those reasons here.) On the other hand, forcing Catholic organizations to provide services they believe are religiously prohibited is a serious burden on religious liberty. It raises some serious constitutional concerns as well.

  1. Like many things, I haven’t made up my mind on this one. Yes, I think employers and insurance companies should be required, in general, to provide access to birth control without a copay as part of a full health insurance plan. That’s good policy. And yes, I think that organizations should follow suit. But whether they should be required to provide insurance that provides access to birth control or sterilization even if it violates strongly held religious beliefs is a much tougher call. 

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We waste a lot of money both publicly and privately on stupid things. Unnecessary wars. Shirts we’ll never wear in public. The death penalty. Incarcerating 1% of the population. Exercise equipment we use once.

I’m not worried that we’ll look back and think that our real mistake was spending money saving kids lives. Let’s do healthcare right. Now. And we can figure out optimization and efficiency later.

Congress has now passed the Health Care Reconciliation Bill. It’s done.

Congress has now passed the Health Care Reconciliation Bill. It’s done.

Health Care Reform Will Cut the Deficit

Obamacare, a blog purporting to “document the truth and consequences of Obamacare,” links to this article by Reason.tv.

3 Reasons Health Care Reform Won’t Cut The Deficit by One Thin Dime

I’ve seen a lot of people saying that they don’t believe the CBO’s estimate—but I haven’t seen any explanation of why they don’t believe the estimate. I thought maybe Reason, by virtue of its name, would offer actual reasons. I was disappointed. Here are the claims and why they are worthless:

"Legislative Trickery." The bill doesn’t include the expensive Doc Fix to Medicare. Every year Congress passes a one year fix. The Democrats want to simply pass a permanent one so we can have honest budgets going forward. It wasn’t included in the bill.

So it’s “legislative trickery” to not put something in the bill that wasn’t in the bill. Right. Except … we’re going to pass a temporary measure every year. Passing a permanent one won’t alter the actual deficit at all. If a Doc Fix is passed later this year, it will increase the projected deficit (unless it’s paid for), but it will only do so by removing a budget gimick we’ve used in the past.

"Higher Premiums." Apparently healthcare reform will increase premiums. Massachussets has something like healthcare reform. Massachussetts has high premiums. Post hoc, ergo propter hoc.

Actually, Massachussetts had high premiums before healthcare reform. That’s why it passed healthcare reform.

"Bad Accounting." Apparently the government is bad at accounting. It’s been wrong before. So maybe the government got its numbers wrong. In fact, it probably did.

But it could be wrong in the other direction, couldn’t it? The CBO didn’t include anticipated savings from Comparative Effectiveness Research. It doesn’t make sense to say, “the government is often wrong, therefore the worst possible thing will probably happen.” You need to point out specifically where the government is wrong. What assumptions did the CBO make that you disagree with? Do you have another estimate that you think is more reliable?

If you’re going to claim that Health Care Reform is going to break the budget, you need something to back that up. So far, I’ve seen nothing.

If you haven’t been watching the health care debate, you haven’t missed anything yet. Except Rep. Alan Grayson's tie.
Edit: Also, John Boehner kept saying “Hell no!” in an effort to pretend that he had emotions. The chairman stopped him and said, “Both sides would do well to remember the dignity of the house.”

If you haven’t been watching the health care debate, you haven’t missed anything yet. Except Rep. Alan Grayson's tie.

Edit: Also, John Boehner kept saying “Hell no!” in an effort to pretend that he had emotions. The chairman stopped him and said, “Both sides would do well to remember the dignity of the house.”

The Republicans hated [the public option] because it’s the first major step towards socialized medicine.

SDS, in reply to this post.

I wouldn’t call it the first step. I would call providing health coverage to the military the first step. Medicare is the second. Medicaid the third. COBRA was probably the 7th or 8th. The (Bush) Medicare prescription drug bill was around the 10th. The public option may be a step down the path toward socialized medicine—but it’s not the first. We took the first step a long time ago.

On a related not, Jeff Miller replied:

The Republicans managed to kill it? Not true. Republicans did not exchange their votes for killing the public option … numerous Democrats did.

Ouch. But fair enough. I was going to credit the Republicans with a political victory. Perhaps it’s wiser to accuse the Democrats of political incompetence.

mythreekittens asked: I have an unemployed son who is 39 years old that we try to help pay rent for. How would he stand on the must buy a policy or be penalized when he has no income?

If he has no income at all, he should be eligible for Medicaid under the new program. It shouldn’t cost him anything if his income puts him below 133% of poverty. For a single person with no children, that is a bit over $13,000 a year. He should be able to get entirely subsidized health insurance.

Under current law, medicaid eligibility varies by state, but usually requires recipients to have children or be in a particularly vulnerable group.

tideofthought asked: Well I know some of the provisions listed by Fox News (not the most reliable source but...) were that Connecticut was getting 100 million for drug aid and some tennessee senators are getting jobs. According to Fox News, which again.... isn't very reliable. But what do you think of those reports?

There is nothing inherently wrong about a Senator or Representative, armed with special knowledge about the needs of her or his state, uses that knowledge to negotiate a change in a bill. This whole process has been full of negotiation, compromise, and, yes, deal-making. That’s what politics is. No single person gets to write the whole bill.

The question isn’t whether there are a bunch of “deals.” The question is whether those deals are any good. For instance, Senator Orrin Hatch (R-Utah) tried to amend a bill to give special help to “states whose name begin with the letter U.” That was a bad amendment proposal. The special payments to Nebraska were also a bad plan.

So does Connecticut need extra funding for a hospital? Is that a bad plan? Tennessee’s healthcare system is in sad shape. Is it in appropriate to direct a bit of extra money there? If it is a good idea state owned banks get special treatment, does the fact that North Dakota is the only state with a state owned bank suddenly make it a bad idea?

Some of these provisions might be bad. If so, let’s criticize the specific provision. Otherwise, I don’t think it matters. There is a fairly decent Huffington Post editorial on this topic.