It’s The Sex. It’s Always The Sex.
What’s the minimum salary requirement to rub your feet on another person’s, stock photo-style?
Why is maternity care specifically becoming such a focal point for conservatives who have decided they object to the concept of health insurance? (Yes, I realize they’re framing it as objecting to Obamacare, but since the argument is, “I shouldn’t have to pay into a common risk pool that covers medical procedures I won’t use,” the argument is actually against health insurance itself, since that’s how it works, and instead is an argument for returning to a cash-only medical payment system.) Garance Franke-Ruta asks the question at The Atlantic, noting that out of the 22 preventive care categories for women that the new law requires are mandatory for coverage, maternity care has become the one that the conservatives who don’t understand how insurance works are getting bent out of shape over.
Maternity care isn’t the only women’s health issue that plans are now required to cover. In fact, there are 22 types of women’s health tests, visits, or prescriptions that insurers must now cover, including contraception. It just happens that besides contraception, none of them has raised the same ire as maternity care. According to a fact sheet at Healthcare.gov, “All Marketplace health plans and many other plans must cover the following list of  preventive services for women without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible” though “only when these services are delivered by an in-network provider.” Including are some of the diagnostic tests used in pregnancy, though not the whole spectrum of maternity needs, where co-pays may still apply depending on the type of plan a woman picks.
She investigates some possibilities, such as the demographic difference between who gets employer-based coverage (which usually has maternity coverage) and the largely part time workers who need to turn to the health care exchanges, the latter of whom are more likely to be unmarried mothers. I think that has something to do with it, of course. I also think it’s just a general expression of contempt for the “47%”, a way to say without coming out and saying that you disapprove of people who aren’t wealthy having children.
Indeed, Franke-Ruta quotes a Romney advisor saying pretty much exactly that. “But having children is more a choice than a random act of nature,” Greg Mankiw wrote, “People who drive a new Porsche pay more for car insurance than those who drive an old Chevy.” In other words, having children should be considered not just a luxury, but an elite luxury, on the level of owning a Porsche, a straight-up luxury of the 1%-ers. At least Mankiw, unlike his fellow conservatives, doesn’t go on about how it’s going to ruin our country if women have fewer kids.
The elitism is a big part of this, but so is the sex part. As Franke-Ruta notes, the only other coverage point that has created as much conservative ire is the contraception benefit. What do contraception and maternity coverage have in common? Both imply that the woman who is using the benefit willingly chose to have sex. It really isn’t much more complicated than that. Which is why Mankiw insists that having children is a “choice”, even though it’s not that simple. Half of pregnancies in this country are unintended. Of those, not an insignificant number result in childbirth because the woman felt that abortion was not really a choice, either because she’s been guilt-tripped by anti-choice propaganda, bullied by family members, or simply couldn’t afford to jump through the rapidly expanding number of hoops that Republicans are putting in place to keep women from abortion. When conservatives say it’s a “choice”, they are pretending that abstaining from sex is a realistic expectation to place on the majority of American women who are not members of the economic elite, full stop. That’s what this is about.
Of course, he thinks that the difference between owning a Chevy and a Porsche is also a “choice”, even though it really isn’t for 99% of people that cannot afford a Porsche. So perhaps part of the problem is that men like him can’t even imagine what it’s like not to be able to say, “You know, I think I want a Porsche. Why not? I can buy whatever I want whenever I want. My car elevator needs more cars for lifting.”
The entire shit-fit over contraception and maternity coverage is equal parts trying to work up anger at Obamacare by exploiting misogyny and trying to advance the notion that sex is a luxury that should only be available to people who can “afford” it, which is a constantly moving target. Should you be Porsche-level rich to “deserve” to have sex? Or will simply being upper middle class do it? Either way, the narrative is about framing sex as something that less affluent people don’t deserve and should be punished for having. Of course, being able to consensually express yourself is a normal part of being a human being, so what this is ultimately about is classifying huge swaths of American people—anyone who really needs insurance coverage to afford contraception and maternity care, basically—as subhumans who should be excluded from even the most basic aspects of human relations.