Should Employers Be Able To Exclude Birth Control From Health Insurance Coverage?

Posted on 19 December 2013

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By Joel Harrison, PhD, MPH

In November, the Obama administration asked the Supreme Court to decide whether for-profit companies can be forced to provide full contraceptive coverage for their employees despite religious objections from their owners. Many people believe that health insurance is something offered by employers, a sort of bonus. In fact, it is part of what I have known as ones “wage package.” Wikipedia calls it “Salary Packaging: a term used to refer to the inclusion of employee benefits (also called fringe benefits) in an employee remuneration package in exchange for giving up part of monetary salary. Such arrangements are entered into most commonly if there are tax or other benefits to be derived by the employer or employee from the arrangement.”

Employers calculate the total cost per employee, including salary, benefits, Workers’ Comp, unemployment insurance, employer’s share of FICA and Medicare, etc. As health costs go up, employers have compensated by freezing or reducing increases in wages and/or cancelling health insurance, switching to reduced coverage and/or increasing employees share of premiums. While there are benefits to employer-sponsored health insurance, e.g. tax benefits, better coverage and lower rates for group coverage, the health insurance is paid for as a part of the employees overall remuneration package.

If employers can exclude birth control from health insurance coverage an absurd thought would be if they somehow became aware that employees were purchasing birth control on their own could employers deduct the amount paid for the birth control from their salaries? Since health insurance is part of what an employee has earned, I see no difference. Carried to its logical extreme, could an employer who is a Jehovah’s Witness exclude blood transfusions? How about an employer who is a Scientologist excluding psychiatric coverage? Or what about a Christian Scientist covering only their own healers?

This is not about First Amendment freedom of religion. It is about employers deciding how the earnings of an employee should be spent. It is about an employer imposing his or her religious values on employees. How much control over employees’ personal lives and choices should an employer have?

Joel A. Harrison, PhD, MPH, a native San Diegan, is a retired epidemiologist. He has worked in the areas of preventive medicine, infectious diseases, medical outcomes research, and evidence-based clinical practice guidelines. He is currently active in supporting the adoption of a single-payer health care system in the U.S. For more information on single-payer go to Physicians for a National Health Program’s website. This article was originally published at East County Magazine.

There is nothing wrong if a person (or company) believes that birth control is immoral. Why can't he (they) have that opinion and refuse to pay for it.

Actually, if we had single payer system then a person or company would not have to make this choice. All care would be provided. It's not fair that businesses have to provide health care.As long as they do, they certainly can make some choices.