Coverage parity: Are the health needs of women medical or something else?

A lot has been in the news about coverage parity for women's health and what it means for insurance companies and employers with healthcare coverage. Yesterday, the aptly named Blunt amendment was defeated in the US Senate, which would have allowed insurance companies to refuse to cover certain services like birth control. Under the yet-to-be-implemented Affordable Care Act, this would greatly reduce the amount of protected essential services, and provide yet another obstacle between women (especially those without means) and their access to legal health services in our country.

As you can tell from that introduction, I happen to hold a certain stance on this topic already. However, it is the reasons for such a stance that hold the most importance. My thought process is thus:

The discussion about the receipt of legal medical services (like birth control) belongs between a woman and her healthcare provider. I know this amendment would not directly infiltrate that relationship in any way, but if a woman knows that her health insurance does not cover medications that some feel are immoral, for her, there is a cost factor in that discussion that could lead to a different decision, a factor has nothing to do with her health. I find this problematic, especially when there is no other segment of medical care that is disputed in the same way. Other kinds of procedures that come close are more elective, and insurance companies often will make coverage exceptions for what is deemed "medically necessary."

Let's talk for a moment about medical necessity. Pregnancy is not a disease, but it is a condition of health that causes physiological changes that are life-changing in scope. Pharmaceuticals have been developed to prevent this condition for women who do not feel their lives or bodies can handle it at any particular time. The medication is prescribed by healthcare professionals, and can be medically indicated for more than just pregnancy prevention (birth control can be very helpful for conditions such as endometriosis and anemia). This sounds pretty medical to me. There is also strong evidence that women who put more space between pregnancies have better health outcomes, including both physical and mental health.

Regarding the moral argument, republican heterosexual married women who only have sex with their husbands need birth control too. That is what makes this argument so interesting to me. If we take a small slice of the population who in the eyes of some are the only ones doing the right thing, and determine they need these services also, the entire argument self-destructs. This is a universal concern, not only for women, but for the men who love and support them, and who are planning or not planning to have families of their own. When I am faced with the medical argument, this whole thing merely becomes an arbitrary decision to cover some services over others, and such practices just don't make sense.

Of course, I know that just because the Blunt amendment failed does not mean that individual states will decide to add birth control to their list of essential services. But at least we do not have a preemptive platform for such "medical discrimination" to take place everywhere. That to me is an excellent step. What do you think?

Read more about the Blunt amendment here.