The Next “Hobby Lobby”: Mandating IVF Coverage

The most cursory survey of the American mass media in July 2014 would have you believe that millions of women are being denied basic medical care and fundamental rights are under total assault because … they can’t get somebody else to buy their abortifacients. Indeed, the U.S. Senate—whose legislative productivity this year suggests it has been the victim of an Obamacare death panel—managed to rush a bill overturning Hobby Lobby to the floor, without committee hearing or public input … only to fail at the hands of Republicans.

Well, has the New York Times given us a glimpse of Hobby Lobby II?

The July 26 issue carries a story whose gist is that government and private insurance does not adequately cover in vitro fertilization (IVF).

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The story opens with the usual human interest story: a 27-year-old nurse complains, after suffering four miscarriages and her husband divorcing her, that “‘I decided I am going to be a mom, whether I am on my own or whether I had a partner by my side.’”

Since “wishin’ don’t make it so”—especially when it comes to parenthood—not having that partner could pose a problem, though nothing a little withdrawal from the sperm bank can’t solve. The bigger problem, though, seemed to be costs: a single round of IVF costs $15,000-$25,000, and “her health insurance, through the California exchange” doesn’t pay for it.

The article then goes on with the usual litany of complaints: only 27 percent of large company-provided insurance plans cover IVF; only 15 states require plans to have an “infertility coverage” component; 4 of the 15 limit mandate to IVF using artificial insemination by husband only; some policies “exclude gay couples and single women” by “defin[ing] infertility as an inability to become pregnant through sexual intercourse”; some states require a documented period of infertility or waiting periods before coverage kicks in; not covering IVF now paves the way for pregnancy complications later; and “the Affordable Care Act did little to expand infertility coverage.”

Let’s consider what’s at issue:

Implicit in this argument is the ongoing divorce of sex from marriage. The wisdom of generations—that a man and woman should fall in love, marry, and have children as a gift from God—is rejected as so much patriarchical enslavement to biology. Bringing children into the world has nothing inherently to do with being married: our 27-year-old nurse is determined to have a baby, “partner or not.” Notice her word choice: she does not even say “husband or not,” but “partner or not.” Parenthood is now to become a unilateral decision; while previous generations might have only dreamed of Amazon-like reproduction, modern technology has now made it possible. Unilateral maternity, of course, was already endorsed in Roe v. Wade and ratified in Planned Parenthood v. Danforth (declaring unconstitutional Missouri’s spousal consent requirement). This “solution” is, of course, essential to cementing the “achievement” of “same-sex marriage,” transgenderism, cohabitation, etc.: to be “human,” man has to transcend his biology.

Advocates of unilateral parenthood have no qualms about ensconcing their view in public policy. The Times article takes it as a given that social policy is just a little behind the curve on this issue, and that eventually—by putting money behind it—IVF will just become standard “treatment.” The article appears in a series “Your Money”—but it’s our money (insurers, exchanges, the public) that will be enlisted to pay for it.

Society has no interest in how society is sustained. The privatization of marriage and parenthood have become so complete in American law that society is seen as having no interest in how members come into it or how society is sustained. This is not just a question of how people are born but of the whole ethos of family life in society. No serious social science research disputes that children need intact families to develop normally; but the current American approach to family policy avoids engaging with that truth.

This is all about adults, anyway. Deliberately making an orphan, i.e., a child bereft of a mother and father, is in principle what IVF does. But IVF has nothing to do with children, except as products manufactured according to parental desires. It has everything to do with adult wants. As Zbigniew Stawrowski notes in his new book, The Clash of Civilizations or Civil War , today’s “sleek barbarians” use the language of tradition (“liberty,” “justice”) to create a new ethic where the strong gain the force of law to effect their desires on the weak, in this case, children. The comments to Times articles are always telling: “I am 40, single, and ready to be a mom.” So, of course, that means she can and should.

Of course, the infertility “treatment” does nothing about the infertility. The biggest paradox, of course, is that the “treatment”—in vitro fertilization—leaves the pathology intact: the woman was infertile before and remains infertile after. What IVF does (like much of contemporary gynecology) is provide wish fulfillment: with no objective notion of healthy or pathological, normal or abnormal, pregnancy and fertility are neither good nor bad, but depend wholly on the will of the woman.

The life dimension is not mentioned at all. The fact that IVF involves manipulation, and typically destruction, of prenatal life does not enter into the Times’ discussion at all. While the article admits that women sometimes undertake multiple pregnancies as a result of IVF, the only downside the Times reports is that women often do this to ensure success because of the expense of even one IVF cycle. The article concludes that this is bad policy, not because lives will be lost, but because it is short-sighted—multiple pregnancies are prone to complications, so failure to pay for IVF up front means incurring larger post-complication costs later. The ethical life issues—multiple fertilization and destruction of embryos, consignment to cryopreservation (freezing), buying, selling, and donating of frozen embryos, use for experimental purposes, selective abortion in multiple pregnancies—receive (like abortifacients in the Hobby Lobby case) no mention, even though under an insurance coverage mandate, employers could be forced to pay for this.

Expect word games to follow. Any discussion to force funding of IVF under insurance policies will undoubtedly use the tug-at-the-heart term “infertility treatment,” while scrupulously avoiding the prenatal implications. One area where a real problem could arise (and abortionists hoisted on their own petard) is over “fertilization.” The American College of Obstetricians and Gynecologists (ACOG) has unilaterally redefined “fertilization” as when an embryo implants into the uterine wall (up to 21 days after fertilization occurs)—so, what is in the Petri dish, an embryo as a result of fertilization, or an embryo waiting to be fertilized by implantation?

Medical resource issues also arise. In a world where medical resources are limited and Obamacare likely to generate rationing, are insurance dollars best spent subsidizing procedures that pose socially controversial moral and ethical issues, destroy human life, and do nothing to overcome the pathology they “treat”? Or is this another case where the generally privileged who can afford to produce children outside of marriage can add “baby” to their list of career accomplishments?

Recently, Jennifer Lahl of the Center for Bioethics & Culture in California completed a trilogy of films about the artificial reproduction industry and its effect on women and children. “Breeders,” “Eggsploitation” and “Anonymous Father’s Day” document the inhumane dimension of this multi-million dollar business masquerading as medicine. They’re worth watching … before artificial reproduction comes to an insurance policy near you.

(Photo Credit: Mark Boster/Los Angeles Times)


  • John M. Grondelski

    John M. Grondelski (Ph.D., Fordham) is a former associate dean of the School of Theology, Seton Hall University, South Orange, New Jersey. All views expressed herein are his own.

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