Written by Christine Charbonneau for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

I am the CEO of Planned Parenthood of the Great Northwest.  I am also an employer.  In the latest round of the War on Women being waged by Congress and the legislatures of the 50 states, much has been written of late about employers; what they want and do not want to insure, and most recently, how employers would be allowed to “weigh in” on the reproductive decisions of our employees.  Spare me.

I have 500 employees in three states.  Like most employers, I have a finite budget for the health insurance I offer my staff.  My goal, as I see it, is to get them the richest package of services I can find for the money I have to invest.  I consider the premiums I pay for this health care to be part of each employee’s compensation.  I also know that covering my staff appropriately results in a happier workforce, with less downtime due to medically related absences, so the investment is good for business, as well. 

Just as I would never dream of telling my staff what to do with their bi-weekly paychecks, I have no interest in telling them how to use their insurance benefits.  After the premium is paid, it is NONE OF MY BUSINESS. 

However, as Planned Parenthood has made it a goal to ensure that reproductive health services are covered in the larger marketplace, I will not purchase a health plan which does not cover contraception, and every outcome of pregnancy, including abortion. Three years ago, while completing the merger of Planned Parenthood affiliates in Western Washington, Alaska and Idaho, I sought to unify the health insurance plans which covered our employees, so that they would all get the same benefits and to save my organization the cost of administering multiple plans.

As we were selecting our insurance provider, I was told that they would be unable to cover abortion services for my employees in Idaho.  I was flummoxed.  After all, this is America, and I was fairly certain that there would have to be a way to buy coverage for a legal procedure.  So I told the plan in question that they would write me the coverage I was asking for, or I would write my $2,000,000 a year premium check to someone who would.

What do you know?  Turns out it was not an insurmountable problem after all.  So, how much did my insistence on birth control and abortion coverage in my largely “women-of-reproductive-age” staff pool add to my cost?  Nothing.  Zip.  Nada.  In insurance-speak, not adding to your premium when you request something they didn’t offer you the first time actually means that you have a rebate coming, but you will never see it.  Those smart actuaries employed by my health insurance carrier sure can do their math.  Birth control, as it turns out, is a really good investment.  It is less expensive than any outcome of pregnancy, even the absolutely best outcomes.  The insurance companies know this.

So, it was no surprise to me when President Obama, who had already exempted churches from offering contraception, exempted religiously run institutions like Catholic Charities, saying that their insurance carriers would make sure people were covered instead.  There was no screaming from insurance companies (and they do know how) about how burdened they would be by that.  The reason being:  it is a better deal for them than paying for some number of complicated pregnancies.  As I said earlier, they are very good at the math.

So what is the issue here?  The coverage doesn’t cost more than not having it.   Not paying for something either way does not infringe on any religious freedom of mine, or of anyone else’s.  

Health insurance should encourage heavy use of preventative care, and insure against medical bankruptcies.  Pregnancies can go seriously wrong, and most wage earners cannot take an unexpected $75,000 hospital bill, in stride.  That is where people lose their houses and families get plunged into desperate straits.  If I could prevent that outcome for others, at absolutely no cost to my company, and did not, I would consider that an immoral act.

Employers don’t have the right to tell their employees how to use their paychecks or their insurance; to do so moves from the sphere of religious freedom into religious control.  No thank you.  Back to business.