Why is Birth Control A Big Deal Again?

Who'd have guessed that women's health would be the hot issue of 2012? First the Susan G. Komen Foundation ignited a firestorm by saying it would withdraw funds from Planned Parenthood for breast cancer screenings. After a backlash, Komen backed down. But that only kicked off more fierce battles.

On February 16, three priests, a rabbi, and a doctor walked into a Capitol Hill hearing room. Sounds like a bad joke, but when those five men testified about denying insurance coverage for birth control, women weren't laughing. The controversy continued when Sandra Fluke, a Georgetown University student who had planned to speak in favor of contraceptive coverage but was turned away, became the symbol of the debate when she was subjected to character attacks. Among other nasty things, Rush Limbaugh called her a slut. Suddenly, it was personal, and the simple fact of using contraception, as 98 percent of American women have, was called into question.

How is it possible that we're debating the morality of birth control? Some social conservatives have resurrected the old argument that having sex without wanting to get pregnant is bad for society. As former GOP presidential candidate Rick Santorum put it: "[Birth control] is ... a license to do things in the sexual realm that is counter to how things are supposed to be." Many abortion rights opponents have also sounded the alarm against contraception, in part because they erroneously claim that some forms, including the Pill, end pregnancy.

But that all-guy panel opposed all birth control. Catholic bishops (and many Republicans) were outraged that President Obama's health-care law mandated that full contraceptive coverage be provided by religiously affiliated institutions. That meant that female employees of Catholic organizations (not including churches) would no longer be denied coverage because of the Vatican's opposition to birth control. (The Church has no such concerns about Viagra.)

Those were the women Fluke was trying to represent. For that, Limbaugh said she was a prostitute and having so much sex that she couldn't walk. "When he talked about me, he could have been talking about any woman who uses contraception," Fluke says. In the ensuing outrage, dozens of Limbaugh's advertisers fled.

Covering birth control is not only popular —63 percent of Americans support the policy —it makes business sense. Data show that every dollar spent on family-planning saves the public almost $4, and that access to birth control helps reduce teen pregnancies. But funding for those services is in constant danger; last year, Republicans almost shut down the U.S. government trying to deny funding for Planned Parenthood because it provides abortions (even though no federal funds pay for abortion).

Though the Great Birth Control Debate is in some ways a nightmarish blast from the past, some see reasons for optimism. Says Cecile Richards, president of Planned Parenthood, "We've seen people across the country who are saying, 'Keep politics out of women's health.'" But much depends on the election: Every Republican candidate supported a failed measure that would have let employers deny workers coverage for anything that violated their conscience, and they've campaigned to overturn the entire health-care law, which is also about to be examined by the Supreme Court. Republicans wouldn't be able to make birth control illegal —but they could make it difficult to get. And that should be enough to get any woman to the polls in November.

President Barack Obama: His Affordable Care Act mandates birth control coverage. Supports Planned Parenthood. His administration rejected an FDA request to make emergency contraception available over-the-counter to girls under 17.

Former Governor Mitt Romney: Supported a Senate measure that would have allowed employers to deny contraceptive coverage to employees on the basis of conscience, and vowed to defund a federally funded family-planning program.

Former Senator and former presidential candidate Rick Santorum: Finds contraception "not OK." Voted to renew funding for women's health, including contraception, to Planned Parenthood and other providers, but has since distanced himself from the vote.

Q: Will all contraception be covered by insurance?

A: As of August 2012, all FDA-approved contraception will be covered without copay.

Q: Will there be a religious exception?

A: After an Obama compromise, religious-affiliated institutions are exempt; insurers must offer complete coverage free of charge.

Q: What if the health-care law is nixed by Congress or the Supreme Court?

A: Twenty-eight states already mandate contraceptive coverage. Women who work for institutions that object to birth control or who are uninsured will have to pay out of pocket, go to increasingly strapped publicly funded clinics, or go without.