Rituparna  Basu

Mandating that certain benefits be included in insurance policies is not a phenomenon new to Obamacare. Fueled by the view that it is permissible to force the medical expenses of some onto others, states have imposed benefit mandates in various forms for more than sixty years. Men are routinely forced to pay for services only women use. Non-addicts are forced to pay for the alcohol and drug rehabilitation of addicts. Bachelors are forced to pay for the marriage therapy of couples. Couples who can conceive on their own are forced to pay for the in vitro fertilization of those who can’t.

According to the Council for Affordable Health Insurance, each mandated benefit can raise the price of our insurance policies by up to 10 percent, and some states mandate more than sixty different benefits.

In a similar vein, Obamacare now requires that “essential health benefits”—benefits within ten federally determined categories—must be included in all policies sold on the individual and small-group markets. State governments and the thousands of lobbyists buzzing in their ears recently wrapped up the process of deeming what counts as “essential.” According to one pressure group, massage therapy, yoga and meditation instruction certainly do.

What this means is not only more expensive premiums but further entrenchment of a health care system in which my individual judgment is declared irrelevant.

As a young and relatively healthy person trying to save for a down payment on a house, I may decide to insure only against catastrophic events. As a female who one day wants children, however, I may want to add coverage against the risk of being unable to conceive.

But instead of leaving insurers free to offer such tailored policies and leaving me free to decide the coverage that best meets my individual needs, the government today dictates to us the coverage that may be bought and sold.

This is the opposite of the direction I want to see our health care system moving.

If an insurance company is willing to offer me coverage for contraception, and if such coverage makes financial sense to me, that’s great. But if the alternative is between being left free to make this choice and being coerced into a policy constructed by a government bureaucrat, I’d rather buy my own contraception, thank you very much. Walmart sells a $9 monthly supply.


Rituparna Basu

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