Archduke Russell John wrote:Oh but wait, this goes against the Left's narrative of the whole fight. It was only because the Republicans where opposed as a group from the outset that forced the Adminstration to make deals that turned out such a truly crappy bill.

Well, no, it's not that the intransigence of the GOP didn't make things harder (a cross-party moderate plan was out, for a start). There are plenty on the 'left' who blame the Blue Dogs and the less than committed President for the outcome, so there's not just one 'narrative' of the Left.

Still, you clearly get my point.

On the EEOC, surely the only effect of the mandate is that if employers don't provide they have to pay a fine. Plenty of Catholic institutions were already abiding by the EEOC rules and State laws and don't appear to have been vocally calling for exemptions.

danivon wrote:On the EEOC, surely the only effect of the mandate is that if employers don't provide they have to pay a fine. Plenty of Catholic institutions were already abiding by the EEOC rules and State laws and don't appear to have been vocally calling for exemptions.

But the mandate is entirely the point. State governments can make that kind of a mandate because they have general police powers. The Federal Government can not because it does not.

Sorry, but you appear to be conflating two points here. Most States, and the EEOC, have already said that an employer who provides prescription cover has to include contraception.

The healthcare act being ruled unconstitutional would not affect that one iota.

danivon wrote:Sorry, but you appear to be conflating two points here. Most States, and the EEOC, have already said that an employer who provides prescription cover has to include contraception.

The healthcare act being ruled unconstitutional would not affect that one iota.

No I am not. The EEOC and state laws are not a mandate. What they is that if an employer provides PBP it must include contraception. Religious organzations can avoid the requirement to provide contraception by not offering a PBP.

The ACA is a mandate. The ACA requires an employer offer a PBP or pay a fine. The HHS promulagated regulations say those PBP's must include contraception. There is no way for an employer to avoid it. If the ACA is ruled unconstitutional, then it goes back to the issue that an employer can avoid it by not offering a PBP.

Further, I think the reason why the Church is so up in arms over the recent HHS regs is because from what I understand, the administration basically lied to the Bishops. It is my understanding that the Congress of Bishops agreed to support the ACA because they were promised a broad exemption from the contraception requirements. However, when the regs came out, that broad exemption was not there.

Going through the first two paragraphs of yours, it's clear we are saying very similar things. Of course, under the ACA an employer can avoid PBP which includes contreception coverage by not providing anything (so paying the fine).

Personally, I don't see why contraception should not be available in the same way as other medical treatments. For example there are women who would be put at risk if they became pregnant, or women for whom taking the oral contraceptive is not primarily for avoiding pregnancy but for dealing with conditions related to menstruation. Either you make a load of exceptions which will then become contentious themselves, or you choose whether to penalise these women for the 'moral' qualms of their employer (or their spouse's employer).

Personally, I doubt this story about a broad exemption, as it would have been made somerhing of back when all the other waivers were becoming known. I suspect that in reality the RCC wanted to pick a fight. Besides, it looks like special pleading to me.

danivon wrote:Personally, I don't see why contraception should not be available in the same way as other medical treatments.

In general concept I agree with you. However, the ER should have the liberty to decide what benefits it wants to offer its EEs and not be mandated by the government. If the ER doesn't offer something its EE want, then it was have a hard time finding people to work for them.

danivon wrote:Personally, I doubt this story about a broad exemption, as it would have been made somerhing of back when all the other waivers were becoming known.

You can doubt all you want but it was a pretty well known concession at the time. Archbishop Dolan came out of the White House meeting and commented on it to the press corp.

Are you sure it wasn't for actual church organisations, not for those 'religious' institutions that have a secular purpose (like hospitals and universities that teach more than divinity/theology)?

Because it would be in keeping with precedent and practice to have the latter.

I still disagree. Employers can decide whether or not to provide a pension, but if they do the pension has to follow certain rules. As we have seen, 28 States already have the rule for employer-provided insurance including contraception. Notwithstanding the argument that State and Federal are different, in the context of 'government', 'employer', 'employee' they are both 'government'. Clearly it has been established that government at some level can impose this regulation on employers, so does your objection move from that to which level of government does it?

If not, how come these States have been able to do so?

danivon wrote: Clearly it has been established that government at some level can impose this regulation on employers, so does your objection move from that to which level of government does it?

Well, it is a combindation of both. I oppose government mandating I purchase something I do not want to need. For example, the state of Pennsylvania changed it's laws about 4 years ago mandating that Autism testing must be covered by every single health insurance policy. My children are beyond the age group to be tested and I am not having any more kids. Why should I have to pay for insurance that includes autism testing when I do not need it.

However, there is also the fact that states have general police powers and can pass those kinds of legislation whereas the Federal Government does not. Hence the reason Massachusetts' mandate is constiutional but the ACA mandate is not.

danivon wrote: If not, how come these States have been able to do so?

Because States have general police powers and can pass these types of legislation.

Archduke Russell John wrote:

danivon wrote: Clearly it has been established that government at some level can impose this regulation on employers, so does your objection move from that to which level of government does it?

Well, it is a combindation of both. I oppose government mandating I purchase something I do not want to need.

You may not want to need it, but that doesn't mean you'll never need it.

For example, the state of Pennsylvania changed it's laws about 4 years ago mandating that Autism testing must be covered by every single health insurance policy. My children are beyond the age group to be tested and I am not having any more kids. Why should I have to pay for insurance that includes autism testing when I do not need it.

Simply, I guess, so that it's affordable for those who do need it. Which is kind of what the general purpose of insurance is. If the only people who took out insurance against X were the people who knew they'd be likely to need it, those people would have masssive premiums, and everyone else would not - but of course if X happened anyway, they'd be uninsured.

Of course, other mandates may mean that people who are 'benefiting' from your subsidy of autism testing coverage are in other ways subsidising your policy. Ultimately, of course, insurance means that those who are lucky subsidise those who are not (with a commission for the insurance company).

However, there is also the fact that states have general police powers and can pass those kinds of legislation whereas the Federal Government does not. Hence the reason Massachusetts' mandate is constiutional but the ACA mandate is not.

Please, Russell, please, can you get out of the rut of equating 'what should/should not happen' with 'what is/is not Constitutional'. It's the conflation thing. I don't really care what is constitutional or not in the context of the debate about why State governments are doing the thing you believe they should not. I get that it probably is constitutional (or it would be challenged by now), so let that argument go.

The government (at some level) clearly can regulate insurance. You may not agree with the regulations themselves, but I guess it's moot.

danivon wrote:

Archduke Russell John wrote:

danivon wrote: Clearly it has been established that government at some level can impose this regulation on employers, so does your objection move from that to which level of government does it?

Well, it is a combindation of both. I oppose government mandating I purchase something I do not want to need.

You may not want to need it, but that doesn't mean you'll never need it.

oops that is a typo. It should be want or need.

danivon wrote:Simply, I guess, so that it's affordable for those who do need it. Which is kind of what the general purpose of insurance is. If the only people who took out insurance against X were the people who knew they'd be likely to need it, those people would have masssive premiums, and everyone else would not - but of course if X happened anyway, they'd be uninsured.

and I get this. And when I was young had hadn't had children, I would have opted for a policy the covers that issue because I might need it. However, now that I don't need it, I do not want to pay for it anymore.

danivon wrote:[Please, Russell, please, can you get out of the rut of equating 'what should/should not happen' with 'what is/is not Constitutional.

Well then I don't understand what it is you are asking. You are asking why some States get away with mandating insurance coverage but the Federal Gov't can't. The answer to that is states have general police power and the Federal Gov't does not. Why don't you tell me what answer you are looking for and I can explain why it is correct or not.

Archduke Russell John wrote:and I get this. And when I was young had hadn't had children, I would have opted for a policy the covers that issue because I might need it. However, now that I don't need it, I do not want to pay for it anymore.

I get that you don't want to. How much of a difference does it make to your premiums? And how much do people younger than you pay for insurance against things that are far more prevalent amonst the middle-aged?

As far as I can see it, what you generally get with insurance policies is coverage 'if' things apply. Insurance companies have whole departments whose job it is to work out how likely the 'if' is to happen to people with particular criteria. Sometimes that 'if' will be zero or vanishingly close to it.

What happens is that you get a standard policy with boilerplates on it. So, a general plan that covers cancers would cover all kinds. Of course, men can't get cervical or ovarian cancer and women can't get prostate cancer*. You don't get different occupational healthcare plans for men and women, but the actuaries are going around calculating the various risks and cost and that goes towards pricing the plan. In order to smooth out the costs and not make some people's premiums too high, there's cross-subsidisation.

Which means that you as a man are likely to have paying for coverage for conditions you can never get via insurance subsidies to female policyholders.

This is how insurance works. Just as people who are at high risk but don't have to claim end up subsidising those who are at less risk but do claim.

It's also why I wonder if it would be possible to quantify how much you are paying for this coverage you don't want (even if you saw a change in premiums when it took effect, there could be many other reasons for a change at the same time).

And while you may not like paying for autism test coverage as a policyholder, what does that have to do with your employer? (which was your original point in this thread, and the issue at hand)

Well then I don't understand what it is you are asking. You are asking why some States get away with mandating insurance coverage but the Federal Gov't can't. The answer to that is states have general police power and the Federal Gov't does not. Why don't you tell me what answer you are looking for and I can explain why it is correct or not.

I think we can settle on the following basic statements:

1) You think that the insurance mandate in Obamacare is unconstitutional; I don't agree, but I'm no expert. It will get resolved later on.
2) You think that the contraception mandate in State laws is constitutional; I have no real opinion
3) You think that the mandate in State laws is wrong, and would be wrong at Federal level; I disagree.

Here's a reason why for that last one:

I was looking at the furore about the set of witnesses in the first session of the House Committee. The Democrats noticed that all were men, and they were allowed one witness as minority, and put forward a woman - a 3rd year law student. The republicans blocked her as 'unqualified'. I'm not too interested in going into the nature of that little spat and the background to it, because the rules of House Committee enquiries seem to make UK Parliamentary procedures look streamlined and efficient, and because clearly there's a huge partisan element (which we also tend to see less of in our parliamentary committees). I was, however, interested to see what she said to the press (in lieu of to the Committee)

What she would have talked about was her friend, who was diagnosed with ovarian cysts. The treatment that would keep the condition under control and allow her to be able tto have children was (ironically) to take birth control. However, because her student health insurance did not cover contraception, and because she could not afford it, she went without, and as a result the cysts got worse and she lost her ovaries.

The problem with the religious principles involved is that in marginal cases like that, they actually meant that not wanting to pay for 'birth control' meant that some women will be far less likely to be able to have kids. Also, that a medical treatment should not fall foul of being the same drug as one that has other uses. You could (in theory) propose coverage for 'medical use only' of contraception. But there lies a whole new morass of extra work involved in policing that as far as I can see.

This is the problem though Danivon. A person working for a religious organization knows the organizations beliefs before they take the job. They have the option of not taking the job if they disagree with the organization's doctrine to not pay for contraception.

Sorry man, but that's just not on. If the organisation is a church, I get it. If it has a secular purpose (and especially if it benefits from government in some way) then no, they are just another employer. As far as I am aware, they are not entitled to practice discrimination on the basis of belief when they employ people other than for explicitly religious posts. Which implies to me that if they can't legally impose their belief system when it comes to hiring, they shouldn't be able to for other employment purposes.

In some areas, what if the only hospital is a Catholic one - do we allow a monopoly on morality imposed on the staff?

Anyway, how much extra does this autism cover actually cost you? We've already seen that in actual fact cover that includes contraception is cheaper than that which doesn't.

archduke

A person working for a religious organization knows the organizations beliefs before they take the job. They have the option of not taking the job if they disagree with the organization's doctrine to not pay for contraception.

But they are not working for religious organizations. They are working for organizations like hospitals and schools that are only "affiliated" with the religious organization.
That is a significant difference.
Do these organizations preclude the hiring of members of other religious affiliations? no. Unless they do so, and the practice wouldn't be tolerated methinks, then they need to accept that the mores of their employees will not be governed by Catholicism.
Moreover, the precedent set by Catholic organizations in 28 states before this caffufle is that they willingly accepted the standard of meeting the requirements of the health insurance.
And finally, if 98% of catholic women use contraception at some point, the moral suasion of the Church seems to be limited. Necessitating the ability to coerce. Not paying for contraception through standard insurance is just coercion. Why should the government facilitate the Church in their coercion? Surely if a moral arguement is telling it doesn't require coercion.

Why does the government (if it is so important to provide "access" to all!) choose to not provide these services? That way the access would be "available" to everyone, and it would not be the responsibility of businesses and employers to have to provide it if there is a moral objection (regardless of religious view).

After all, the Government can provides services so much more effectively.