Oh, the logic of Illinois voters. A girl actually said this to Mitt Romney in Illinois yesterday. Distractions on the whole contraceptive debate aside, this is the other side of the coin when it comes to misunderstanding the debate: Birth control is never “free.” Neither is other coverage.

Yet, many  media outlets either cover up the fact they understand this, or they simply do not get it. For example: TPM described the question as “One woman asked him about contracpetion access.” Are you kidding me? Her quote was ridiculous and that is how you write it up?

Somebody pays for it — Always. Whether it’s condoms at public schools or requiring health insurance plans to cover the pill, it gets paid for by somebody. In the case of the latter, it gets paid for everybody else’s insurance. How hard is that to understand?

A reporter emailed noted economist Steven Landsburg about the Sandra Fluke debate. Here’s an excerpt:

As you might suspect, I disagree with your assertion that “All she said, in effect, was that she and others want contraception and they don’t want to pay for it.”

You should read Landsburg’s response, it is really good but it is too long to post here.

This is one of the more misunderstood or not known facets of how health insurance works. Before the Affordable Care Act, States did most of the regulating of insurance plans. Sure, the feds had a role in regulating it to a degree, especially regarding Medicare, but mostly it was by States. (This is still true, but the federal role has and will likely continue to increase.)

Here’s how new mandates often happen at the State level:

A group of people would petition State legislators, and say: “We’re sick and tired that our evil insurers won’t cover [insert disease or procedure.]”

Let’s say it’s something obscure like Tay Sachs.

“We want you to mandate that all insurance plans in our state have to cover Tay Sachs.”

The legislator agrees and writes a feel-good bill. Nobody wants to oppose the Tay Sachs law because it would make them look “bad.” It becomes law. Bad law.

While this is a very sad disease, it’s a very similar argument as the contraceptive debate. Should I be required to pay higher premiums to cover Tay Sachs in other people when I’ll never need the coverage? No, I shouldn’t.

Should I be required to pay more to cover other peoples’ elective procedures that I would never want? I shouldn’t, but the law sometimes requires that I do.

(Note: This is a different argument than my premiums paying for a procedure that some stranger and I mutually want, which is an important distinction.)

State legislators, of course, are happy to please these constituents and constituents like them over and over. In some states the amount of mandated coverage is absurd.  Thousands of mandates later, people think they’re getting this stuff for “free.” They’re wrong. It is definitely paid for, by everyone. It should be paid for by those who are willing to pay for it.

A better solution would be to allow people to pick the insurance that’s best for them, without mandating coverage of obscure illnesses or personal choices like contraception, or mandating anything at all. That’s what a free-marketer would think is the best approach, but sadly, health insurance is hardly a free market.

Absent that, letting people shop for insurance across State lines (which is what Republicans proposed as an alternative to the Affordable Care Act) would be acceptable.

So, to that girl in central-Illinois, I say yeah “Yay freedom” because you wanting “free birth control” takes the free out of freedom.


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