A good deal has been said — with a good deal of passion, exaggeration and confusion — about the requirement that all organizations, including those affiliated with the Catholic Church, must provide cost free access to birth control and abortion-inducing drugs in health insurance policies.

Much of the debate has had to do with the extent to which a woman’s right to birth control trumps Catholic doctrine and religious freedom, but there are several non-theological issues that could stand more discussion because of their implications for broad health care reform and for the internal logic of the 2010 health care legislation.

One is the issue of who pays for the contraceptive mandate. When Catholic leaders objected to the requirement, the administration responded by announcing that neither Catholic organizations nor their employees would have to pay for the coverage, but that insurance companies would have to include it in policies without cost.

Most church leaders quickly recognized this embarrassingly thin fig leaf for what it is, a distinction without a difference.

Whatever one’s view of the concept of birth control as a “basic health care right,” the idea that insurance companies will actually absorb the cost of the mandate is absurd. The cost will carefully not be linked to any product or treatment, but will nonetheless be included in higher premiums.

The administration’s notion that shifting the cost resolves the moral issue and that no one will notice the winks and nods its “accommodation” requires is an insult to Catholics and to anyone who cares a wit about truth in advertising.

An even more important question is how access to birth control, a matter of personal choice, got transformed into an entitlement that must be included in health insurance coverage.

The argument is that the absence of coverage would result in unwanted and expensive pregnancies, and would indirectly endanger women’s health. The problem with the argument is that contraceptives are a relatively small expense for most working women, and women who purchase contraceptives directly often pay less than would be the case if the products were included in an insurance policy.

Employers other than Catholic-affiliated organizations who wish to include contraceptive coverage in insurance policies are free to do so, and many do. But the argument that women would not have low- cost access to birth control without insurance coverage is simply not true.

If the mandate does not enhance access to contraceptives for employees and does not necessarily lower costs, then there is no coherent reason why church- affiliated organizations should not be able to exclude coverage on the grounds of religious freedom and conscience.

Employers currently have this right. The administration’s mandate takes it away, effectively turning an employee benefit into an entitlement with inclusions directed by the government.

One of the chief selling points of the Affordable Care Act was that it would make health insurance less expensive, but the practical effect of the legislation is to accelerate the transformation of insurance into pre- paid, ondemand coverage that includes virtually any product or treatment remotely related to health care.

Some may think this is a great idea, but it is no wonder that insurance companies have already said that the comprehensive coverage the legislation requires will be more expensive than many current policies.

The great irony here is that many of those who argue that birth control must be covered in health policies are the same ones who complain about the high cost of insurance.

In a system in which true insurance for unexpected illness and costly treatments was combined with a health savings account for preventive and minor care, the church-state imbroglio over contraceptive coverage would never have arisen, and Catholic women who choose to adhere to the teachings of their church wouldn’t have to pay for coverage that violates those teachings.

For years other Catholic women who quietly accepted and practiced birth control have had an unofficial and unspoken “Don’t ask, don’t tell” understanding with the church that may have made both a little uneasy, but allowed more-or-less peaceful co- existence. This understanding has been made much more difficult by the president’s determination to impose his social values on the church.

The conflict over the birth control mandate has given us a foretaste of what is likely yet to come in Obamacare, of the command and control nature of the legislation, and of the bureaucratic omnipotence and arrogance that is guiding its implementation.

Martin Jones lives in Freeport.

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