SJ Chapman, Resident Blogger (’12, Northwestern University Law School)
November 15 kicked off open enrollment season for health care, so I’ve had insurance on the brain. I already took advantage of my “free” preventive/screening doctor’s appointment and obtained “free” FDA-approved contraception months after they became available to me under the Affordable Care Act, fearing the courts would whittle these mandates down before you can say reproductive freedom.
I’ve become especially interested the economics of the matter. There’s no question that the Affordable Care Act has caused a lot of spending at every level. The public at large funded legislators to draft and debate the legislation. For-profits and not-for-profits have funded litigation either fighting or defending the law. Folks who didn’t have insurance prior to the law must now buy it or pay a penalty.
While I like to think that the insurance companies are taking some responsibility for the reproductive health of the insured because they must now cover things like copays for well-women visits and contraception, my economic sense tells me that’s too good to be true. It might seem like insurance companies would happily pay for preventive reproductive health services because it would save insurance companies money in the long run. Under this reasoning, the cost of being on birth control long term and getting a pap every 3 years would be less than paying for unintended pregnancies or late-stage detected cervical cancer. Unfortunately a recent New York Times article suggests that this isn’t the case.
So I suspect my insurance company figured out how to spread out what would have been my office visit and pharmacy copays so that they are still being paid out of our pockets instead of the insurers. Maybe just adding a dollar to every monthly payment by (1) a man and (2) a woman who doesn’t get contraception by choice and (3) a woman who doesn’t get contraception because it is not age-appropriate would cover these costs. Or perhaps increasing all deductibles by $50 would make up for the difference.
Ultimately is all this spending worth it? Well, my answer is emphatically yes, because one of the ends of the Affordable Care Act is to expand reproductive health access to many people for whom it was previously cost-prohibitive. This is a cause I earnestly support. Even if it means we are all paying higher taxes, deductibles or premiums, I’m happy to support reproductive justice by spending a little more to increase access to reproductive health services.