Organizations like the American federal government, the Catholic Church, and nearly half the states in US want to or do limit a woman’s access to abortion in their employer-provided health care packages. The new wave of legislation, policy, and social commentary focused on women’s reproduction has been framed as a matter of social policy, but ignored are the economic and legal requirement of equal pay for equal work. These legislative actions hope to limit women’s choices when it comes to reproduction but by limiting the cash value and practical value of health insurance for women and their ability to work uninterrupted by pregnancy, these policies mandate pay inequity between genders.
During World War II, the American federal government instated restrictions on raising pay for private sector employees in an attempt to control inflation and show fairness to troop compensation. They left in a loop hole that allowed companies to offer additional benefits like sick days and health insurance to employees because these perks were seen as non-inflationary. In the 1940’s, employer-provided health care coverage exploded and became a new compensation for private workers during the war and the tradition of having employers in America provide health insurance was born.
Even today, the health insurance coverage is an important part of any employee compensation package. Many employees choose to stay in their current position to preserve their medical coverage. Some companies increase the salary or hourly pay of employees who are otherwise covered by insurance if they decline the company policy.
The average cost of health insurance premiums for an individual ranges from $5,000-$15,000 per year. The cost of insurance has increased at a rate higher than inflation every year for several years, making insurance harder and harder for an individual to afford. At the same time insurance is skyrocketing in cost, the salaries have essentially stagnated. The stalled salaries make the ever more costly insurance policies an even more important aspect of their compensation.
The value and cost of an insurance policy is based on what the policy does and does not cover. Contraceptive coverage is a substantial benefit to women and not covering it is a tremendous cost for a female employee to absorb.
The annual cost of birth control for women ranges in cost from $0 for the rhythm method to $6,000 for sterilization. An abortion costs between $225 - $10,000 depending on the state, trimester, method, and complicating factors.
In a study done by the March of Dimes in 2007 found that the average expenditures for delivery raged from $7,205 to $10,958 with an average out of pocket expense of $463 - $523 by the woman. That does not include lost wages due to maternity leave, sickness due to pregnancy, recovery time, and nursing.
The value of health insurance to both employee and employer is not only in the dollars to buy it, but in keeping a person well enough to work with as few missed days as possible. Limiting coverage of birth control and of abortion hugely decreases the value of a health insurance policy for women because it does not help her prevent conditions that can greatly increase her missed work days, including pregnancy, delivery, nursing, child illness days, and menstrual issues. Prenatal care, delivery, recovery, nursing, and postnatal care can add up to several months off work, a huge economic disadvantage for women in both simple dollar amount and workplace opportunities.
In 2003, the Agency for Healthcare Research and Quality (AHRQ) found the average charged for prenatal care and postnatal care was $133 per visit including blood tests, doctor charges, and ultrasounds. The Kaiser Family Foundation (KFF) found that the average cost of prenatal care was about $2,000. Folic acid vitamins run about $9 a month or $81 during a pregnancy. Dental exams are encouraged in early pregnancy. Extra ultrasounds can run $200 each. Any complications will increase these costs dramatically, up to $1,000. Many of these expenses will be covered by insurance, but with co-pays and deductibles, the cost of prenatal care can add up to a major expense.
The KFF and AHRQ calculated the average number of doctor’s visits for prenatal and post natal care as 12-14. Private health insurance will not cover the cost of taking time off work to go to the doctor or lost opportunity that comes from being out of the office to go to the doctor.
There is a significant gap in pay between women with children and women without. Women with children make less money than women with children. A study by Cornell University in 2005 found that women with children make $11,000 dollars less a year than women without children and that each child increases the pay gap. Dr. Michelle Budig of the University of Massachusetts, Amherst, found that the difference in pay goes up by $1,100 per child. Women with children were also found to be less desirable to employers and were 44% less likely to be hired than a woman without children. A Government Accountability Office report in 2010 found that female managers without children made more than women with children.
Men did not experience these same disparities in fatherhood/non-fatherhood pay or lessened desirability and in fact had increased advantage by having children. The GAO report found that for every dollar a man with children makes, a woman with children doing the same job makes $0.79 cents.
The Equal Pay Act of 1963 required equal pay for men and women doing the same work. The Equal Pay Act and subsequent legal cases have determined that pay is not limited to salary but includes benefits like vacation, sick leave, gasoline allowances, life and health insurances.
Insurance plans for public sector and/or private sector employees are prohibited from providing abortions in twenty four states. The women who are in the federal government’s employ are not allowed to choose an insurance plan that covers abortion. Several states are proposing legislation that would allow companies to opt out of covering contraceptives if they have a moral objection. The federal government has allowed exceptions to be created for religious organizations who have a moral objection to contraceptives. These laws limit the compensation of women to lower than that of a man doing the same job by requiring their health insurance be less valuable and forcing them to assume a cost (reproductive health services) that men doing the same work do not have to assume.
In states where women previously had birth control and abortion coverage their policy loses value, thus lowering the value of their compensation packages. There are no reported cases of employers increasing the pay of women in their employ to compensate for the lost value or insurance companies lowering the cost for the lost service. That means that every woman who has lost reproductive health coverage has taken an substantial pay cut.
Women who did have insurance and women who previously did not have coverage but enter a company that does, will be making substantially less than men doing the same work because the overall value of their compensation packages will always be less than that of a man.
Choosing not to have children can be an economic and professional decision. Not only do mothers get paid less, once a woman has children she would be less able to leave her job and find suitable employment making future mobility or increased pay by finding a new employer less possible. This lack of mobility and lower pay makes birth control and abortion coverage an even more valuable benefit to women.
The issue of private birth control and abortion coverage has been mired in a bog of religious dogma, political stances, and heated moralistic language. It is however, an important economic issue assuring equal pay for equal work.
Ww2 labor wages limitation
States that limit compensation
8,000 per person 2009
Cost of birth control
Birth Control Calculator
Cost of abortion
Equal Pay Act of 1963
Cornell University Study of Women’s Pay
GOA Report about motherless managers
March of Dimes Study