Mandate watch: We seem to live in a magical world!


Who does Obama’s accommodation accommodate: Our public discourse rarely makes sense.

Often, twists and turns in the public discourse seem to happen by magic. For ourselves, we remain confused by the semi-magical solution Obama came up with last week—his “accommodation” on the birth control mandate.

His accommodation did work, as if by magic. The whole tilt of the public debate quickly turned in his direction. On the politics, that's the tilt we prefer. Having said that, we were a bit puzzled by the way the accommodation would work.

Explanations were few, as always.

Yesterday, our puzzlement grew. On the front page of the New York Times’ Business Day section, Katie Thomas wrote this semi-surprising news report. “Self-Insured Complicate Health Deal,” the headline said. Reading Thomas’ gloomy assembly of facts, it was hard to see how Obama’s accommodation was supposed to accommodate a fairly wide range of players:
THOMAS (2/16/12): The Obama administration thought it had found a way to ease mounting objections to a requirement in the new health care act that all employers—including religiously affiliated hospitals and universities—offer coverage for birth control to women free of charge.

It would make the insurers cover the costs, rather than the organizations themselves.

But the administration announced the compromise plan before it had figured out how to address one conspicuous point: Like most large employers, many religiously affiliated organizations choose to insure themselves rather than hire an outside company to assume the risk.

Now, the organizations are trying to determine how to reconcile their objections to offering birth control on religious grounds with their role as insurers—or whether there can be any reconciliation at all. And the administration still cannot put the thorny issue to rest.
We were surprised to learn that “most large employers” self-insure, since the accommodation doesn’t seem to accommodate folk in that situation. And good lord! When Thomas said “most,” she wasn’t kidding:
THOMAS: Nationwide, 60 percent of workers with health insurance were covered by a self-funded plan in 2011, according to the Kaiser Family Foundation’s annual survey of employer health benefits. Among large employers, the number is even higher. Eighty-two percent of covered workers at companies of more than 200 employees had self-funded plans.

Insurance industry experts and Catholic groups said they did not know how many religiously affiliated organizations self-insure, but they said the number was likely to mirror the national trend. Many of the organizations are large employers, including hospital systems and universities.
Say what? As if by magic, the accommodation flipped the public debate. But based on Thomas’ report, it seems the accommodation has a ways to go. Or something.

We simply don’t understand this topic. We will guess the chances are good that you may not understand it either. Last night, we saw Rachel Maddow citing this Los Angeles Times report as she discussed the way those 28 states already have a mandate like the one Obama proposed.

We haven’t had a chance to review that report in detail. But we’ve learned to be very careful about accepting Maddow’s representations in matters like these. Meanwhile, in just a quick skim, we’ll have to admit that we noticed this paragraph:
GEIGER (2/16/12): The original Obama regulation, released in January, went further than any state by requiring that women receive contraceptive benefits without co-pays or deductibles, as required for all preventive care under the healthcare law. But in exempting only some religious organizations, the administration followed what had become the approach used by many states.
Say what? “Went further than any state?”

We don’t understand this topic. We will guess that you may not understand it either; we’ll be reading more about it this weekend. But our discourse often seems to work by a form of magic.

One thing’s for certain—information and clarity are rarely part of the brew.

Lizard brain reaction alert: We’re not discussing what you think should happen in the best of all worlds. We’re discussing the facts and the logic of the public discussion—a discussion we don’t understand.

Maybe you do! Having said that, where can we get down a bet?

We'll be studying that L. A. Times report. In our view, the New York Times has still been very sketchy when it comes to the basic facts of this case.


  1. The actual details are unimportant compared to the novel: the "war on women." It's the left's turn to use a dumb-ass culture war issue to distract voters.

  2. This comment has been removed by the author.

  3. Look. It's really simple. If the insurer offers contraception services then the overall cost of the insurance policy will be lower than if the covered women have unintended pregnancies. Pregnancies are damned expensive. The only way there is a difference for the self-insured is that they pay for the contraceptives up front and reap the reduced costs later.

    Say full cost of contraception is $600 per year. Say an uncomplicated childbirth is about $6000, and complicated ones go up rapidly. So a year's contraception for 10 women will save a lot of money.

    The issue is timing, of course. But that's the magic of insurance. You are buying into a pool of insured and the cost of the insured event can occur the next day. Does anyone really think that large companies do not factor this in when they decide to self-insure? If a company is large enough to self-insure it already has reserved to cover the current medical events. No state regulator would let them self-insure otherwise, and for damned sure no competent actuary would set up the plan without reserves.

    This is another media-created talking point designed to be an attack on the Obama administration. There is nothing real about it. It's pure combat propaganda, the kind of stuff the right wing does for fun when they are shooting and killing people.

    1. Taking your argument to it's logical conclusion, the obvious solution to this dilemma is the mandatory sterilization of ALL woman at the age of 12. This would solve SO many problems! Women would be able to go through life without the constant stress of worrying where their next contraceptive pills are going to come from. Those dreadful pregnancies (so inconvenient!) would be a thing of the past. Not to mention, they would be able to experience all those wonderful orgasms without the fear of consequence. A new Golden Age for women, no doubt!

      And think of what a boon it would be to the insurance industry. No controversies about providing contraceptives. No more covering those terribly expensive pregnancies and their complications. They will be saving SO much money that insurance polices will cost next to nothing, as the addition cost savings of Obamacare fully kick in. A win-win for everybody involved!

      And just think, with the human race dying out, Mother Earth/Gaia will be able to return to it's pure natural state!!! What a boon to all the greenies/treehuggers out there. We should do this for that reason alone!

      Back to the gist of your comment. NOBODY (but you) is arguing about the COST of contraceptives. The issue is whether or not the government can mandate the providing of contraceptives by institutions that reject their use for religious reasons. Which you COMPLETELY FAIL to address. I would expect no less from you.

      As far as your remarks about the "right wing" "shooting and killing people", it's now clear that it's not just that you have pure hatred for Mitt Romney, it's not just that you're insanely jealous of those doing better than you, it's that you utterly despise those don't ascribe to your liberal / progressive / socialist ideals. It all boils down to "The OTHER TRIBE is PURE EVIL and I HATE THEM!", doesn't it?

    2. This argument seems to assume that people will not utilize birth control unless it's covered by their health insurance. I don't think that's the case. I think almost all of those who intend to use birth control will do so, even if they have to pay for it themselves.

    3. @TobyTucker:

      ".... that it's not just that you have pure hatred for Mitt Romney, it's not just that you're insanely jealous of those doing better than you,"

      You said exactly the same thing about your tax antagonist a few posts away. Apparently, anybody who doesn't accept right-wing talking points is a Romney hater, and pure envious evil.

      We could speculate why you take this peculiar tone on a site which wouldn't be of obvious interest to you, hand ow it is you have nothing better to do.

      Then again, if you and David in Cal keep it up, it's doubtful anyone will care to read or write comments here much longer. Perhaps that's the idea, in the same way negative campaigning discourages voting -- you so disgust people that they simply give up. It's been highly effective, particularly for Republicans.

      In any event, you're well on our way to it....

    4. This article, Insurance industry could take hit from birth control mandate, provides both support and opposition to AnonymousFeb 17, 2012 04:20 PM, who said that adding birth control & abortion coverage would reduce health insurance costs. The article says that most health insurance companies expect the requirement to increase their costs. OTOH the Administration says that adding this coverage to the Federal Employees Health Benefit System actually reduced insurer costs in Hawaii.

  4. That should have said "when they are NOT shooting and killing people."

  5. There's no "magic" as to how this controversy died down in the media. Once again the MSM is doing it's best to cover for Obama. They find some notable liberal "Catholics" who declare this accommodation "solves" all the problems and circulates these remarks widely, while completely abandoning any attempts to explore the details of said accommodation and whether or not it actually does "solve" anything. (This article excepted.)

    Meanwhile, the objections of the Bishops are NOT publicized or only mentioned is passing, in the vein of "The problem is solved, what are they complaining about NOW?" As far as the MSM reporting of the Republican response is concerned, it can be characterized as "Obama solved the problem and now the GOP is just mad because he's so smart. Why are they always being so mean to him?", with only a cursory and/or dismissive explanation of their objections.

    So it's no wonder there's no controversy in the media, the media doesn't WANT any controversy. As you point out, this "solution" doesn't really "solve" anything, it's just a matter of kicking the can down the road a bit. Right now we seem to be in a holding pattern as HHS hasn't promulgated a Final Rule on this. Once that happens, this could very well blow up all over again.

    1. The majority of Roman Catholics didn't and don't have a problem with Obama's original regulation. THE MAJORITY. Not a minority, not a plurality, but the majority don't have a problem with it.

      Only the Republicanophilic Catholic hierarchy, like Archbishop Timothy Dolan and his ilk, and a ragged band of ranting right-wingers like yourself are up in arms about this. Instead of addressing Christ's chief concerns in the New Testament Gospels, which focus on love, taking care of the poor and sick, etc., they are fixated on abortion, same-sex marriage, and the like. Catholic organizations do the work of Christ, but these "bishops" have spent far too much time shuffling pedophiles around like a three-card monte game. This newest bit of hysteria is par for the course.

      The reality is, they want to control women's bodies, their rights to personal autonomy, and them. Santorum has laid it all out there.

      We endlessly hear from the establishment media what the crank bishops want. Over and over. And that even louder-mouthed Bill Donohue, who represents no one but himself and the bishops.

      But what about Roman Catholic women? Why not hear from them? Oh, that's right, because people like you don't give a damned what they have to say. And believe me, an aspirin between the knees ain't cutting it!

  6. Perhaps one reason for the confused reporting is that official wording for Obama's accomodation doesn't yet exist. It's my understanding that at the moment the officially promulgated rule is the one Obama's accomodation will revise.

  7. What I don't udnerstand is why the Bishops see a moral difference between (1) paying money directly to their employees who then go out and spend a fraction of that money on birth control and (2) paying money to an insurance company on behalf of their employees and having the insurance company spend a fraction of that money on birth control.

    If there is a moral difference, can't we just mandate that Catholic Hospitals pay their employees an extra $600 a year in cash which will allow their employees to afford paying for birth control.

    1. I'm pro choice. However, from the Roman Catholic POV, maybe the moral difference is something like the difference between (1)An employer paying wages that its employees are free to use for Ku Klux Klan dues, vs. (2)An employer directly enrolling its employees as KKK members.

      IMHO, if the federal government wants to provide free birth control to all Americans, it would be cleaner morally for them to provide it directly to the people, rather than involve employers and insurance companies. I think the direct approach would also be cheaper, as it would eliminate insurance company and employer overhead. Furthermore the direct approach would include unemployed people. They need free birth control coverage more than employed people do.

  8. I know people who currently work for large Catholic universities and who currently have birth control coverage. There is a deductible, but that doesn't change the fact that the coverage is there. Why isn't anyone highlighting the extreme hypocrisy of screaming "freedom of religion" when they've been providing the coverage all along? Anyone in hell yet?

  9. David in Cal - YES -- universal health care! Let's do i! But your analogy is a little weak. It's more like this: Employer creates a fund that allows employees to join whatever organization they want. Government says: if you're going to create such a fund, you have to allow your employees to join even groups you find objectionable, so long as they are legal. You cannot create such a fund and then say, but you can't join X group. Make more sense?