Rituparna  Basu

This election season, perhaps in an attempt to win the so-called women’s vote, the marketing efforts for Obamacare targeted my gender. “Thanks to the Affordable Care Act,” Representative Nancy Pelosi and Secretary of Health and Human Services Kathleen Sebelius cheered in one editorial, “a new day for women’s health has arrived.” They’re referring to the provision that all health plans must now include coverage for contraception and other women’s services—and must do so without charging co-pays or deductibles for them.

Given that I have two X chromosomes and am not Catholic, you might be surprised to learn that I’m not cheering along. After all, what woman of child-bearing age would be against free, FDA-approved birth control?

But the alternative is not really between free contraception and contraception I have to pay for. It’s between two visions of the American health care system: one in which I’m free to make decisions and one in which that freedom is eroded.

For other types of insurance, I have much more control over the coverage I judge best for my individual situation. If I lived in Oklahoma, I may want to choose a policy with robust windstorm coverage, since the region is more prone to tornados. Damage from earthquakes is rare in the state, so I may decide to forego buying coverage for that. But if I lived in the earthquake-prone state of California, as I do, I may choose to load up on earthquake-damage protection. If I lived along the Gulf Coast, on the other hand, I may decide it’s a good idea to purchase protection from hurricane damage.

I can hardly make the same kinds of decisions when it comes to my health insurance, which is much more heavily controlled by the government. For example, when the government mandates that all health plans include coverage for contraception (never mind without co-pays or deductibles), what that means is everyone, including every man and every woman who is past child-bearing age, is required to purchase coverage for that benefit. The purpose is to make us pay a portion of its cost for those women who use it.

Rituparna Basu

Rituparna Basu is a healthcare writer and research associate at the Ayn Rand Institute.