I've heard some leftish commentators opine that HL's position is really one of greed -- they just don't want to pay the cost of birth control. I haven't agreed, partly because I understand that from an employer's perspective, pregnancies are expensive and bothersome.
Regardless, the more significant point is that for the insurer, pregnancy is a lot more expensive than the alternative. How expensive? Just slip across the orange vulva, and I'll explain with some grossly oversimplified statistics. (Update: As VCLib has pointed out, HL is self-insured, so the following discussion more properly applies to large employers who contract out for group health insurance, and who cast a much broader anti-BC net than HL -- for example Notre Dame University. I've edited the text below to reflect this -- including slicing out a probably unwarranted slash at HL's compensation structure)
It's pretty hard to figure out exactly what a "typical" birth costs, and it's more or less impossible to characterize the "typical" birth to a slave-wage employee of an anti-human employer like Hobby Lobby an employee of one class or another of employers, but let's do the best we can.
Various sources indicate that a "typical, normal birth" in the US runs somewhere from 6 to 12 grand. (Partly, that depends on whether you consider C-sections "normal"). However, the birth itself is only part of the story, and the costs skyrocket when the birth is "atypical".
Apparently, we spend about $110,000,000,000 per year on maternity and newborn healthcare. There are about 4,000,000 births per year in the US, so let's keep the numbers simple and say that on average, the live birth of a child costs about $26,000 in more or less immediate medical costs.
Note, by the way, that insurance premiums don't normally go up when a family with children adds another. In other words, that $26K can represent a BIG loss for the insurance company.
By contrast, a prescription for BC pills runs somewhere between $200 and $600 per year. If we split the difference and say $400/year, then what we get is an indication that if withholding BC pills from subscribers results in just 1 additional pregnancy for every 65 subscribers, it's a loss for the insurer.
I need to follow that up with a few observations. One: I have no doubt that the rate of additional unplanned pregnancies is going to be a lot higher than 1 in 65 subscribers. Yes, that's just my opinion. Two: I suspect that the socioeconomic class of the people we're discussing -- people for whom BC is a real financial challenge -- is such that they are at above-average risk for a complicated pregnancy. They are more likely to be smokers, for example. Three: Since they are not planning a pregnancy, they are more likely to be abusing alcohol (and other drugs) in the early weeks of the pregnancy when the fetus is at highest risk. Four: I suspect that the actual unplanned pregnancies are of above-average likelihood to be in women of late-child-bearing age, because such women are likely to underestimate their likelihood of getting pregnant, and thus take statistically unwise risks. Note that such women are at much higher risk for a complicated pregnancy and neonatal complications.
In other words, my 65:1 ratio almost certainly underestimates, by a very large amount, the real relative cost of providing BC versus not providing BC. If I pull a number out of nowhere, say, that there is a 1 in 30 risk per child-bearing-age female subscriber of an unplanned pregnancy in a given year (note that this number assumes that most of the women will be at least trying to use self-funded birth control, or the rate would be more like 1 in 3), and that the pregnancy is somewhat more likely to be an expensive one -- let's say they average 30K, instead of 26K -- then the expected cost of not providing BC is 1000/woman/year, versus the 400/woman/year cost of BC.
I'm going to be honest, I have no idea what the real numbers are.
However, I promise you that the insurance companies know exactly what those numbers are, and they damned well ought to apply good ol' american market principles to their product pricing.
The bottom line: Any insurer offering a plan that does not include prescription birth control and emergency contraception should charge more for that plan. A lot more.
I would be very interested to see Hobby Lobby's the employers' response.