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Contraception Without Romance: The Entangled Political Economy of State and Federal Contraceptive Insurance Mandates

  • Marta Podemska-MikluchEmail author
Chapter
Part of the Remaking Economics: Eminent Post-War Economists book series (EPWE)

Abstract

Even though effective contraception has been widely available and used in the U.S. since the 1960s, access to affordable contraception became a political issue in the early 1990s and culminated in the adoption of the federal contraceptive insurance mandate in 2011. This paper analyses the emergence of contraceptive mandates in the context of Virginia Political Economy, focusing on James M. Buchanan’s distinction between a productive and a redistributive state. Buchanan would surely view insurance mandates as an expansion of a welfare state and an activity indicative of constitutional anarchy. To understand the coordinated patterns of societal coordination within constitutional anarchy I employ Richard E. Wagner’s framework of Entangled Political Economy. I conclude that the push for state and federal contraceptive mandates was driven by a rent-seeking effort oriented at increasing the demand for more profitable forms of contraception.

References

  1. American College of Obstetricians and Gynecologists (ACOG). (2011). ACOG Practice Bulletin No. 121: Long-Acting Reversible Contraception: Implants and Intrauterine Devices. Obstetrics and Gynecology, 118(1), 184.CrossRefGoogle Scholar
  2. Arrow, K. J. (1951). Social Choice and Individual Values. New York: Wiley.Google Scholar
  3. Bailey, M. J. (2006). More Power to the Pill: The Impact of Contraceptive Freedom on Women’s Life Cycle Labor Supply. The Quarterly Journal of Economics, 121(1), 289–320.  https://doi.org/10.1093/qje/121.1.289.CrossRefGoogle Scholar
  4. Bailey, J., & Blascak, N. (2016). The Effect of State Health Insurance Benefit Mandates on Premiums and Employee Contributions. Applied Economics Letters, 23(14), 1042–1046.  https://doi.org/10.1080/13504851.2015.1130786.CrossRefGoogle Scholar
  5. Becker, N. V., & Polsky, D. (2015). Women Saw Large Decrease in Out-of-Pocket Spending for Contraceptives After ACA Mandate Removed Cost Sharing. Health Affairs, 34(7), 1204–1211.  https://doi.org/10.1377/hlthaff.2015.0127.CrossRefGoogle Scholar
  6. Brennan, G., & Buchanan, J. M. (1980). The Power to Tax: Analytic Foundations of a Fiscal Constitution. Cambridge: Cambridge University Press.Google Scholar
  7. Brown, S. S., & Eisenberg, L. (1995). The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families. Washington, DC: National Academies Press.Google Scholar
  8. Buchanan, J. M. (1954). Social Choice, Democracy, and Free Markets. Journal of Political Economy, 62(2), 114–123.CrossRefGoogle Scholar
  9. Buchanan, J. M. (1968). The Demand and Supply of Public Goods. Chicago, IL: Rand McNally.Google Scholar
  10. Buchanan, J. M. (1975). The Limits of Liberty: Between Anarchy and Leviathan (Vol. 714). Chicago: University of Chicago Press.Google Scholar
  11. Buchanan, J. M. (1978). Cost and Choice: An Inquiry in Economic Theory. Chicago: University of Chicago Press.Google Scholar
  12. Buchanan, J. M. (1987). The Constitution of Economic Policy. The American Economic Review, 77(3), 243–250.Google Scholar
  13. Buchanan, J. M. (1999). Politics Without Romance: A Sketch of Positive Public Choice Theory and Its Normative Implications. In The Logical Foundation of Constitutional Liberty, Vol. 1. The Collected Works of James M. Buchanan. Indianapolis, IN: Liberty Fund.Google Scholar
  14. Buchanan, J. M., & Congleton, R. D. (1998). Politics by Principle, Not Interest: Towards Nondiscriminatory Democracy. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  15. Buchanan, J. M., & Tullock, G. (1962). The Calculus of Consent: Logical Foundations of Constitutional Democracy. Ann Arbor: University of Michigan Press.CrossRefGoogle Scholar
  16. Chesler, E. (2007). Woman of Valor: Margaret Sanger and the Birth Control Movement in America. New York: Simon & Schuster.Google Scholar
  17. Cox, C., Damico, A., Claxton, G., & Levitt, L. (2016, October). Examining High Prescription Drug Spending for People with Employer Sponsored Health Insurance. Kaiser Family Foundation. Available at https://www.healthsystemtracker.org/brief/examining-high-prescription-drug-spending-for-people-with-employer-sponsored-health-insurance/.
  18. Dailard, C. (2004). Contraceptive Coverage: A 10-Year Retrospective. Guttmacher Report on Public Policy, 7(2), 6–9.Google Scholar
  19. Dills, A. K., & Grecu, A. M. (2017, February). Effects of State Contraceptive Insurance Mandates. Economics and Human Biology, 24, 30–42.  https://doi.org/10.1016/j.ehb.2016.11.004.CrossRefGoogle Scholar
  20. Djerassi, C. (1970). Birth Control After 1984. Science, 169(3949), 941–951.  https://doi.org/10.1126/science.169.3949.941.CrossRefGoogle Scholar
  21. Djerassi, C. (1989). The Bitter Pill. Science, 245(4916), 356–361.  https://doi.org/10.1126/science.2667135.CrossRefGoogle Scholar
  22. Emons, W. (1997). Credence Goods and Fraudulent Experts. The RAND Journal of Economics, 28(1), 107–119. https://www.jstor.org/stable/2555942?seq=1#metadata_info_tab_contents.
  23. Equal Employment Opportunity Commission. (2000). Decision on Coverage of Contraception. Available at https://www.eeoc.gov/policy/docs/decision-contraception.html.
  24. Feldstein, P. J. (2011). Health Policy Issues: An Economic Perspective. Chicago and Arlington, VA: Health Administration Press; Association of University Programs in Health Administration (AUPHA).Google Scholar
  25. Finley, B. (2012, February 24). Cloudy Contraception Costs. FactCheck.org. Available at https://www.factcheck.org/2012/02/cloudy-contraception-costs/.
  26. Food and Drug Administration. (2008). Therapeutic Equivalence of Generic Drugs. Letter to Health Practitioners. Rockville, MD: Food and Drug Administration.Google Scholar
  27. Gold, R. B. (1998). The Need for and Cost of Mandating Private Insurance Coverage of Contraception. Guttmacher Report on Public Policy, 1(4), 5–7.Google Scholar
  28. Goldin, C., & Katz, L. F. (2002). The Power of the Pill: Oral Contraceptives and Women’s Career and Marriage Decisions. Journal of Political Economy, 110(4), 730–770.CrossRefGoogle Scholar
  29. IMS Institute for Healthcare Informatics. (2014). “Medicine Use and Shifting Costs of Healthcare”.Google Scholar
  30. Institute of Medicine. (2011). Clinical Preventive Services for Women: Closing the Gaps. Washington, DC: The National Academies Press.  https://doi.org/10.17226/13181.
  31. Johnson, M. (2014). James M. Buchanan, Chicago, and Post-War Public Finance. Journal of the History of Economic Thought, 36(4), 479–497.  https://doi.org/10.1017/S1053837214000571.CrossRefGoogle Scholar
  32. Karpilow, Q. C., & Thomas, A. T. (2017). Reassessing the Importance of Long-Acting Contraception. American Journal of Obstetrics and Gynecology, 216(2), 148.e1–148.e14.  https://doi.org/10.1016/j.ajog.2016.10.012.CrossRefGoogle Scholar
  33. Kindell, K. (1999). Prescription for Fairness: Health Insurance Reimbursement for Viagra and Contraceptives. Tulsa Law Journal, 35, 399.Google Scholar
  34. Liebman, D. (2014, July 9). Does Contraceptive Coverage Pay for Itself? A Review of the Evidence. The Incidental Economist. Available at https://theincidentaleconomist.com/wordpress/does-contraceptive-coverage-pay-for-itself-a-review-of-the-evidence/.
  35. Merck. (2018). 2017 Annual Report.Google Scholar
  36. Mintz, M. (1985). At Any Cost: Corporate Greed, Women, and the Dalkon Shield. New York: Pantheon Books.Google Scholar
  37. Mosher, W. D. (1982). Trends in Contraceptive Practice: United States, 1965–76. Vital & Health Statistics. Data from the National Survey of Family Growth, Series 23, No. 10. Superintendent of Documents, U. https://eric.ed.gov/?id=ED292000.
  38. Mosher, W. D., & Jones, J. (2010). Use of Contraception in the United States: 1982–2008. Vital and Health Statistics, 29, 1–44.Google Scholar
  39. Mulligan, K. (2015). Contraception Use, Abortions, and Births: The Effect of Insurance Mandates. Demography, 52(4), 1195–1217.  https://doi.org/10.1007/s13524-015-0412-3.CrossRefGoogle Scholar
  40. National Research Council. (1990). Developing New Contraceptives: Obstacles and Opportunities. Washington, DC: National Academies Press.Google Scholar
  41. OpenSecrets. (2018a). Lobbying Spending Database. OpenSecrets.org. https://www.opensecrets.org/lobby/lookup.php.
  42. OpenSecrets. (2018b). Lobbying Spending Database: Health. OpenSecrets.org. https://www.opensecrets.org/lobby/indus.php?id=H&year=2018.
  43. Ott, M. A., & Sucato, G. S. (2014). Contraception for Adolescents. Pediatrics, 134(4), e1257–e1281.  https://doi.org/10.1542/peds.2014-2300.CrossRefGoogle Scholar
  44. Podemska-Mikluch, M. (2014). Public Policy: Object of Choice or Emergent Phenomena? Lessons from the Polish Medical Reimbursement Act. In S. Horwitz & R. Koppl (Eds.), Entangled Political Economy (Advances in Austrian Economics, Vol. 18). Bingley: Emerald Group Publishing.Google Scholar
  45. Podemska-Mikluch, M., & Wagner, R. E. (2013). Dyads, Triads, and the Theory of Exchange: Between Liberty and Coercion. The Review of Austrian Economics, 26(2), 171–182.  https://doi.org/10.1007/s11138-012-0180-x.CrossRefGoogle Scholar
  46. Podemska-Mikluch, M., & Wagner, R. E. (2017). Economic Coordination Across Divergent Institutional Frameworks: Dissolving a Theoretical Antinomy. Review of Political Economy, 29(2), 249–266.Google Scholar
  47. Raissian, K. M., & Lopoo, L. M. (2015). Mandating Prescription Contraception Coverage: Effects on Contraception Consumption and Preventive Health Services. Population Research and Policy Review, 34(4), 481–510.  https://doi.org/10.1007/s11113-014-9353-6.CrossRefGoogle Scholar
  48. Rose, S. L. (2013). Patient Advocacy Organizations: Institutional Conflicts of Interest, Trust, and Trustworthiness. The Journal of Law, Medicine, and Ethics: A Journal of the American Society of Law, Medicine & Ethics, 41(3), 680–687.  https://doi.org/10.1111/jlme.12078.CrossRefGoogle Scholar
  49. Rothman, S. M., Raveis, V. H., Friedman, A., & Rothman, D. J. (2011). Health Advocacy Organizations and the Pharmaceutical Industry: An Analysis of Disclosure Practices. American Journal of Public Health, 101(4), 602–609.  https://doi.org/10.2105/AJPH.2010.300027.CrossRefGoogle Scholar
  50. Snyder, A. H., Weisman, C. S., Liu, G., Leslie, D., & Chuang, C. H. (2018). The Impact of the Affordable Care Act on Contraceptive Use and Costs among Privately Insured Women. Women’s Health Issues: Official Publication of the Jacobs Institute of Women’s Health, 28(3), 219–223.  https://doi.org/10.1016/j.whi.2018.01.005.CrossRefGoogle Scholar
  51. Sollom, T. (1995). State Actions on Reproductive Health Issues in 1994. Family Planning Perspectives, 27(2), 83–87.CrossRefGoogle Scholar
  52. Sollom, T. (1997). State Actions on Reproductive Health Issues in 1996. Family Planning Perspectives, 29(1), 35–40.Google Scholar
  53. The Guttmacher Institute. (1994). Uneven & Unequal: Insurance Coverage and Reproductive Health Services. New York: AGI.Google Scholar
  54. The Guttmacher Institute. (2018, March 14). Guttmacher 50th Timeline. Guttmacher Institute. https://www.guttmacher.org/about/guttmacher-50th-timeline.
  55. Thomas, A., & Karpilow, Q. (2016). The Intensive and Extensive Margins of Contraceptive Use: Comparing the Effects of Method Choice and Method Initiation. Contraception, 94(2), 160–167.  https://doi.org/10.1016/j.contraception.2016.03.014.CrossRefGoogle Scholar
  56. Time. (1966, August 19). Contraception: The Safe and Effective Pills. http://content.time.com/time/magazine/0,9263,7601660819,00.html.
  57. Wagner, R. E. (2009). Property, State, and Entangled Political Economy. In W. Schafer, A. Schneider, & T. Thomas (Eds.), Markets and Politics: Insights from a Political Economy Perspective (pp. 37–49). Marburg: Metropolis.Google Scholar
  58. Wagner, R. E. (2016). Politics as a Peculiar Business: Public Choice in a System of Entangled Political Economy. Cheltenham: Edward Elgar.Google Scholar
  59. Walmart. (2017). Retail Prescription Program Drug List.Google Scholar
  60. Watkins, E. S. (2012). How the Pill Became a Lifestyle Drug: The Pharmaceutical Industry and Birth Control in the United States Since 1960. American Journal of Public Health, 102(8), 1462–1472.  https://doi.org/10.2105/AJPH.2012.300706.CrossRefGoogle Scholar
  61. Westoff, C. F., & Ryder, N. B. (2015). The Contraceptive Revolution. Princeton, NJ: Princeton University Press.Google Scholar
  62. Yandle, B. (1983). Bootleggers and Baptists – The Education of a Regulatory Economists. Regulation, 7, 12.Google Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  1. 1.Gustavus Adolphus CollegeSt. PeterUSA

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