The Other McCain

"One should either write ruthlessly what one believes to be the truth, or else shut up." — Arthur Koestler

‘Give Me Equality — and Pay My Bills!’

Posted on | May 10, 2018 | 2 Comments

 

How much does it cost to get pregnant? Well, a bottle of wine and maybe the price of some candles, doing it the old-fashioned romantic way. Fortunately, my wife doesn’t drink, so we’ve got six kids at an even cheaper rate, but my point is that pregnancy is usually free.

Not everybody does things the old-fashioned way, however, and two years ago, this became the subject of a lawsuit in New Jersey:

[In August 2016] four lesbian women in New Jersey sued the state after being denied insurance coverage for infertility treatments because they couldn’t prove they had tried to conceive naturally.
A New Jersey law from 2001 requires that insurance companies cover infertility treatment as well as in vitro fertilization and other assisted reproductive technology (ART). But there’s a catch: The patient must prove that her infertility has extended for up to “two years of unprotected sexual intercourse.” Since that law was enacted, though, two important things happened. The Supreme Court made same-sex marriage legal, and Obamacare prohibited insurance policies from discriminating again patients based on their sexual orientation. In the first lawsuit of its kind since marriage equality and the passage of Obamacare, the New Jersey women are arguing that the law discriminates against same-sex couples because they obviously can’t get pregnant through unprotected sex with their partners.
“These women are already going through what can be a difficult experience, and they have the added stress of affording it financially and the added insult of being treated like a second-class citizen,” Grace Cretcher, the plaintiffs’ lawyer, told the New York Times. “The specific wording of the New Jersey mandate is particularly egregious and one of the most specific and exclusionary.”
Despite progress on a national level, the New Jersey couples’ experiences might not be unusual. Only 14 states require that insurance companies have at least one plan that covers infertility treatments, which can include intra-uterine insemination, drug therapies, and IVF. But many of them use language similar to the New Jersey law and define infertility as the inability to become pregnant after a certain period of unprotected sex, as opposed to only a medical diagnosis indicating infertility or sexual orientation that excludes intercourse. Even in states like California where laws have been updated to protect insurance discrimination against LGBT people, not all policies are in compliance, according to Shannon Minter, the legal director of the National Center for Lesbian Rights. As a result, same-sex couples no matter what their medical circumstances may be, are often told they don’t qualify for coverage.

 

Am I the only one who sees the insanity of such a “discrimination” claim? This is how health insurance mandates — laws requiring coverage for certain treatments — increase insurance rates for everyone. When legislators begin telling insurance companies how to run their business, so that they must provide insurance to high-risk customers or extend coverage for expensive treatments, the companies have no choice to raise rates for healthy patients who don’t need the mandated “protections.”

New Jersey lawmakers who imposed mandatory coverage for infertility treatments in 2001 either did not realize or did not care how this mandate would, in effect, shift costs by requiring everyone to pay higher premiums to cover the people who demanded these treatments. When they passed this law, however, probably none of the legislators imagined that lesbians would someday claim they were victims of discrimination — suffering “the insult of being treated like a second-class citizen” — because of the way the New Jersey law was written.

This is a perfect example of what happens when governments attempt to replace the private decision-making of businesses and consumers with the fiats of legislators and regulators. Do women with gynecological problems have a “right” to expensive treatments that may help them become pregnant? This is what the New Jersey law implies — that insurance companies must provide these treatments, to make women with reproductive disorders “equal” to healthy women, and never mind the costs imposed or any potential unintended consequences.

While I am sympathetic to women with OB/GYN problems, my sympathy is somewhat diminished when it is demanded that health-insurance companies be required by law to provided coverage for expensive procedures like in vitro fertilization. Because I know a few things about reproductive health, I am aware that many cases of infertility could be avoided, if people were better educated about various risk factors. “Fertility delayed is fertility denied,” as every student of demographics knows, and a woman who easily could have become pregnant at age 20 or 25 may find that she is unable to conceive when she’s 30 or 35:

Maternal age is the most significant factor related to a woman’s ability to conceive. While many women today are waiting to become pregnant, the ovary’s ability to produce normal, healthy eggs declines with age, increasing the risk of chromosomal abnormalities and unsuccessful implantation and pregnancy.

This is not a secret. It’s widely known. Why, then, do so many women postpone motherhood so long that they increase the risk that they’ll never become mothers at all? The most common answer is college education, and because most college educated women are from middle-class backgrounds (and earn higher wages than non-college-educated women), their higher risk of infertility means that mandating coverage for such treatments actually tends to subsidize relatively rich women.

So 19-year-old Thelma is raising her baby in the trailer park, and her husband’s working down at the tire store, and his health insurance premium keeps going up because, across town in a posh 4BR/3BA home in an upscale neighborhood, 34-year-old Ashleigh with her master’s degree and her aging ovaries can’t seem to get pregnant and state law mandates that the insurance company pay for IVF treatment ($12,000 per cycle) to enable her to have a baby.

Liberals may defend this as “social justice,” I prefer to call it crazy.

All of my libertarian objections to government inference in the health-insurance business would be sufficient to make me oppose mandatory coverage for fertility treatments, even if such a law applied only to heterosexual women, Now, however, we are told that “equality” requires that everybody must pay to help lesbian couples get pregnant. What next? Will gay men demand payments to hire surrogate mothers for them?

Probably shouldn’t make such jokes, lest we give them ideas . . .

What brought this to mind today was that a Tumblr blog run by a lesbian couple trying to have a baby asked their readers: “How many IUIs did it take before your BFP?” (IUI stands for “intrauterine insemination,” a procedure that costs about $3,000 per cycle; BFP stands for “Big F–king Postive,” i.e., a positive result on a pregnancy test.) One of their Tumblr followers answered: “We went through 16 IUIs, and actually got our BFP on a ICI we did at home as a last attempt before IVF.”

Holy smokes! It may have cost $50,000 for 16 failed IUIs before this couple got pregnant via ICI (intracervical insemination) and did they pay this out of their own pockets or was it covered by their health insurance? What if this coverage became mandatory nationwide?

Never trust anyone arguing for “equality.” There’s always a catch to such arguments, and that catch usually involves a demand for money.



 

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