In the debate about whether state and federal law should mandate contraceptive coverage, advocates have made numerous false claims about the supposed need for and effects of the mandates.
Myth: "Failure to cover contraception constitutes sex discrimination."
Facts: Most health plans do not cover purely elective procedures or services. Some health plans do not cover contraception or sterilization procedures for either men or women. These plans are not discriminatory, because they treat men and women equally in terms of coverage of benefits.
Proponents of contraceptive mandates argue that because some health plans voluntarily cover Viagra all health plans should be required by law to cover contraception. But Viagra, used properly, treats a medical condition and restores reproductive function while contraception does just the opposite.
Myth: "Contraceptive mandates will reduce the abortion rate by half."
Facts: More than half (58%) of all abortion patients were using contraception during the month when they became pregnant.1 Only 11% of abortion patients have never used a method of contraception.2 Moreover, studies have shown that once contraception is more widely available, abortion rates may actually rise.3 In Maryland, for example, the first state to enact a contraceptive mandate, the number of abortions rose by 1,226 the year after the mandate took effect.4
Myth: Contraception is basic health care.
Facts: Contraception is an elective intervention that stops the healthy functioning of healthy women's reproductive systems. Medically it is infertility, not fertility, that is generally considered a disorder to be treated.
Contraceptives also have numerous side-effects and risks of serious complications. The side-effects of the pill include headaches, depression, decreased libido and weight gain.6 Documented serious complications include heart attacks,7 cervical cancer8 and blood clots.9 Recently, a class-action lawsuit, brought by 123 English women against three pharmaceutical companies, alleges that a form of the pill -- the "third generation pill", -- has caused death, strokes and life-threatening blood clots.10
Proponents of contraceptive mandates have also obscured important consequences of many of these mandates. Most contraceptive mandate laws and proposed legislation, including the proposed federal mandate ("EPICC") would:
- Violate rights of conscience. Seventeen states have passed contraceptive mandates and one state has adopted such a mandate by administrative regulation. Of these eighteen states, only one protects the moral and religious beliefs of individuals and entities who object to contraception. Thirteen protect the conscience of religious employers but of these, six have adopted such narrow definitions of "religious employer" that many Catholic organizations do not qualify for the conscience protection. The proposed federal mandate would explicitly override existing conscience protection in the state mandates, requiring all religious employers (including the United States Conference of Catholic Bishops) to provide contraceptives.
- Cover so-called "emergency contraception," which has primarily an abortifacient effect. "Emergency Contraceptives" are multiple dose oral contraceptives taken after intercourse. The pills have four possible mechanisms: (1) suppressing ovulation, (2) altering cervical mucus to hinder the transport of sperm, (3) slowing the transport of the ovum and (4) inhibiting implantation of the newly conceived human embryo. This last mode of action ends the life of a developing human being and is therefore abortifacient. In fact, "[t]his mode of action could explain the majority of cases where pregnancies are prevented by the morning-after pill."11 Because of its misleading nomenclature and its approval as a "contraceptive" by the FDA, "emergency contraception" is mandated by almost all state contraceptive mandates. Only one state (North Carolina) has expressly excluded "emergency contraception" from its mandate.
- Undermine parental rights. Once contraception becomes a mandated prescription benefit, the benefit will apply to all beneficiaries of the health plan, including minor children. And in many cases, physicians are allowed to provide contraceptives to minors without parental consent, so children will often be able to obtain contraception covertly.12 In HMOs, where a family is covered for all services by one capitated fee, parents may not receive any notification that their child has been given a prescription contraceptive drug.
- See Stanley K. Henshaw & Kathryn Kost, "Abortion Patients in 1994-1995: Characteristics and Contraceptive Use," 28 FAMILY PLANNING PERSPECTIVES 140, 144-145 (July/August 1996).
- See id.
- See, e.g., David Paton, "The Economics of Family Planning and Underage Conceptions," 21 J. HEALTH ECON. 27 (2002).
- Based on data provided by the Maryland Department of Health and Mental Hygiene.
- See Robert A. Hatcher, et al., CONTRACEPTIVE TECHNOLOGY, 419 (1998).
- See Bea C. Tanis, et al., "Oral Contraceptives and the Risk of Myocardial Infarction," 345 NEW ENGLAND JOURNAL OF MEDICINE 1787 (December 20, 2001).
- See CONTRACEPTIVE TECHNOLOGY at 418.
- See Jeanet M. Kemmeren, et al., "Third Generation Oral Contraceptives and Risk of Venous Thrombosis: Meta-analysis," 323 BRITISH MEDICAL JOURNAL 131 (July 21, 2001).
- See Kaiser Network Daily Reproductive Health Report, "British Lawsuit Filed Against Makers of 'Third-Generation' Birth Control Pills," October 2, 2001 at http://www.kaisernetwork.org/Daily_reports/rep_index.cfm?DR_ID=7228 (visited March 19, 2002).
- F. Grou & I. Rodrigues, "The Morning After Pill, How Long After?", 171 AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 1529 -34 at 1532 (1994).
- See Alan Guttmacher Institute, State Policies in Brief: Minors' Access to Contraceptive Services (Feb. 1, 2002) (listing 34 states where some minors can consent to contraceptive services, and 16 states with no explicit policy).