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The Blunt Amendment: Making Health Care Worse for All

By now, you’ve probably heard of the Blunt Amendment. It is the response of Republican Senator Roy Blunt to the Catholic whining over Obama’s compromise on coverage of birth control. Not content to have the requirement lifted that they pay for birth control coverage without a copay (the insurance companies will absorb the cost, which is likely to reduce their overall expenditures), they instead want to be able to control the kind of health care their employees are offered.

Blunt wrote them a bill to let them do just that. He even helpfully provides a copy of that bill in pdf form on his website, suggesting that he’s proud of that fact. But what does the bill say? Well, you might be surprised, since contrary to coverage in the popular press, this bill has implications far beyond women’s reproductive health care. All wrapped up in invocations of Thomas Jefferson and the rights of conscience is this small piece of very effective language:

A health plan shall not be considered to have failed to provide the essential health benefits package described in subsection (a) (or preventive health services described in section 2713 of the Public Health Service Act), to fail to be a qualified health plan, or to fail to fulfill any other requirement under this title on the basis that it declines to provide coverage of specific items or services because—

(i) providing coverage (or, in the case of a sponsor of a group health plan, paying for coverage) of such specific items or services is contrary to the religious beliefs or moral convictions of the sponsor, issuer, or other entity offering the plan; or

(ii) such coverage (in the case of individual coverage) is contrary to the religious beliefs or moral convictions of the purchaser or beneficiary of the coverage.

There’s a bit more, mostly declaring compliance with this to be nondiscriminatory and stating that no one may discriminate against an employer because of their totally not discriminatory beliefs. There’s also a bit reaffirming that this is an individual right, giving individuals the opportunity to sue in federal courts over this–“this” being their ability to deny health care coverage to others, whose rights are apparently limited to GTFO. Even in this economy.

This bill, which Blunt describes as just rolling back parts of the Affordable Care Act, goes well beyond that and becomes just the latest in a long line of great arguments for single-payer health care. If it passes, you’re going to have to learn quite a bit about your prospective employer before you can decide whether you can work for a company.

  • Have a kid with ADHD? Are you sure you know how the Mormon head of the company interviewing you–not just the leaders of the Mormon church–feels about stimulants when their use isn’t recreational?
  • The company just hired a Scientologist to run the place? Does that mean everyone receiving treatment for mental illness–those receiving talk therapy as well as those on medications–needs to start looking for a job?
  • Need some treatment derived from or tested on animals? (The answer is yes.) How does the boss feel about PETA?

The National Women’s Law Center lists a few more implications you may not have thought of:

  • A plan could claim a moral or religious basis in order to refuse to cover HIV/AIDS screenings or counseling.
  • An employer could refuse to cover screening for Type 2 Diabetes in its plan because of a religious or moral objection to a perceived unhealthy lifestyle.
    […]
  • A small employer could offer a plan that does not cover maternity care for unmarried women in its plan, claiming that such coverage violates its belief that sex and procreation are permissible only within the marital relationship.
    […]
  • A man purchasing an insurance plan offered to women and men could object to maternity coverage, so the plan would not have to cover it, even though such coverage is required as part of the essential health benefits.
  • An individual could object to coverage of vaccines for children, so the plan could then not be required to do so.

They also note that an individual state could qualify as an “entity” under this amendment and that by nullifying requirements to be nondiscriminatory, the amendment could allow discrimination against a number of protected classes.

  • An insurer could refuse to provide coverage of any health care service to an interracial couple because of a religious or moral objection to such relationships.

It really doesn’t matter what the “religious beliefs or moral convictions” are. It doesn’t even matter how sincere they are if an administrator or judge can be intimidated or convinced. It certainly doesn’t matter whether any of these decisions are based in reality or sound medical policy.

No, what really matters is that those who want to control women’s lives and bodies have been thwarted, and that must not be allowed to happen. It can’t be prevented by any remotely sound legislation, so we end up with this monstrosity that will allow anyone to interfere with the health care of anyone they employ in any unreasonable way they see fit because they believe in it.

The Senate Democrats are looking to force a vote on this bill this week.

Obviously believing that the amendment will be defeated, Senate Democrats relished the challenge, and the ability to put Republicans on the opposite side of women’s health. Barbara Boxer, the head of the Environment and Public Works committee and the manager of the surface transportation bill, didn’t even seem to be interested in a “side-by-side amendment” affirming the President’s compromise or enshrining it into statute (she said “others may offer” such an amendment, but that she would not). This is less about policy than about letting Republicans hang themselves with their retrograde views about birth control.

I wish I were as confident as they are, but my health insurance isn’t nearly as well guaranteed. I’ve worked for the same company for over nine years, but it was acquired a couple of years ago, and I’ve lost track of all the people who have run the place in that time. I can all too easily imagine having to worry about my health care every time that happened.

Then, too, I’m less relaxed about what people will do in the name of religion. I saw the most liberal senator of my time vote for DOMA because of his religion. No, I get to just watch and wait (because both my senators are relatively liberal) and hope this nasty mess goes up in the kind of flames that will keep anyone from reintroducing it any time soon.

Comments

  1. says

    Here’s another one: According to the Catholic Church, if you divorce and remarry, you’re an adulterer. So, would a Catholic hospital be able to refuse spousal coverage to their employees who remarried?

  2. says

    As the head of Gigantico Insuromatic Corporation, I refuse to provide coverage for anything on the list of things for which we provide coverage. The basis for my refusal is a moral opposition to anyone anywhere spending money on anything that is not physically located on my yacht.

  3. DaveL says

    How about Christian Scientists? Would they get out of covering… well, just about everything that qualifies as modern medical care?

  4. D. C. Sessions says

    You want Sharia in America? How about refusing coverage for males providing health care to women, women providing health care for men, or any group with both women and men caring for anyone?

    All perfectly legal.

  5. F says

    There’s a joke including co-pray in here somewhere, I just can’t make it work the way I’d like.

    Insurance companies are already bad enough without the religious exemptions. As it is with the rest of the medical industries. Walking even further away from evidence-based whatever isn’t going to help.

  6. Anonymous Atheist says

    Or even the religious/moral conviction some regressive people still have that women should be housewives and not in the workforce. You can’t not hire women (in theory), but with this you could decide that women who work at your company won’t get any health insurance; even refuse spousal coverage to men whose wives work at other companies. Go home and use your husband’s health insurance. Don’t have a husband? Get one.

  7. shari says

    This is just flat-out ‘we won’t cover you if we don’t like you’. I used to work for a small company owned by two well-off guys. When it came time to review benefits – And Save Money – their stance was ‘it’s your choice to have kids, sorry, it’s gonna cost you. We aren’t going to pony up more money just because you want to breed. Oh, the ones you have Already got sick too? Well, that was your choice. Sucks to be you, but if you want better coverage, that’s coming out of your paycheck, not my wallet.” Privately owned companies can already offer crappy insurance without reasons other than ‘bottom line’. This bill just makes it even easier to be legally lousy employers.

    Of course, if your health care was crap, and you had to miss a lot of work because of it, there were still a lot of ways to fire you too, MN being the ‘at-will’ state we are….

  8. pyrobryan says

    I’ve always thought that a blanket exception for objection based on conscience was a bad idea. Where do you draw the line? Some people don’t believe in using medicine, can they deny all health care coverage? Could you deny coverage to a gay employee for living an “unhealthy lifestyle”?

    If they’re going to offer an exception, it should solely for religious institutions (like a church) that employ members of their own religion/sect. So a catholic church that employs only catholics could opt to not cover contraceptives, but a catholic hospital that employs non-catholic doctors and staff cannot.