Saturday, February 11, 2012


Let’s leave aside for a moment the First Amendment aspect of the HHS mandate that all employers provide their employees with insurance that covers contraception. I know that sounds weird but, frankly, I just find that entire topic awfully upsetting and have a couple of other, rather intemperate posts in the works about that.

Instead, let’s look at this from a slightly different angle. If I understand the law behind the HHS mandate, this is happening solely at the discretion of the Executive branch. That is, HHS was empowered by Obamacare to decide what services must be covered by any employer-provided insurance plan. So far as I know, that decision doesn’t get made once and set in stone. (I could be wrong about that but given the continuing development of new treatments, it would seem that HHS must have the ability to change what is required.) That would seem to mean that a different Administration could impose different requirements. So future Administrations could - depending on their political viewpoint - do any of the following:

Rescind the requirement that employer-provided insurance cover contraception.

Require employer-provided insurance to cover treatment to “cure” people of homosexuality, including psychiatric, drug, and religion-based approaches.

Require employer-provided insurance to cover children born to or adopted by married employees but not those born to or adopted by unmarried employees.

Not require employer-provided insurance to cover pre-natal testing designed to detect the sorts of birth defects that often lead to abortions.

Not require employer-provided insurance cover anything more than palliative care for children born with birth defects that could have been detected early enough for an abortion.

Not require employer-provided insurance cover whatever conditions a particular Administration considers preventable: sexually transmitted diseases; lung cancer in smokers; Type 2 diabetes or heart failure in the obese; pregnancy out of wedlock; accidentally self-inflicted gunshot wounds.

Employers could, of course, still choose to provide coverage that is not required but since (as I understand it) the Executive branch will have at least some say in how insurance companies are allowed to set their rates, an employer might find it difficult to locate an insurance company willing to provide a policy that an Administration would prefer not be written. And, of course, the more limited coverage will be cheaper so ...

It should be quite a ride.