Vermont has made it easier for both women and men to get birth control services. For the first time, new legislation requires that vasectomies are added to insurance policies — with no co-pay for the patient.
Gov. Peter Shumlin is expected to sign the bill soon.
Not many conversations about access to birth control start with the male anatomy.
But at his clinic in White River Junction, Dr. Richard Graham, who has been performing vasectomies since the 1970s, says they should.
“It's permanent birth control,” he says.
Why that makes a difference? Dr. Graham says that many women are unable to take birth control pills or use other forms of contraception. In fact, many methods can have negative side effects.
“[Vasectomies] are a permanent fix for people who don’t want to have any more children” Graham says.
Rep. Chris Pearson, the vice chairman of the House Healthcare Committee, oversaw the bill that will add vasectomies to health care coverage in Vermont.
For Pearson, this legislation was personal. His decision to get a vasectomy was a choice he and his wife made together. He says including it in health care coverage seemed obvious.
"To me, it wasn’t a mystery, it wasn’t scary. It was just sort of a no-brainer that when we’re talking about different birth control options, we ought to include vasectomies," Pearson says.
The federal Affordable Care Act only addresses contraceptives as it relates to women. Pearson's hunch is that that reflects a long tradition of reproductive choices weighing mostly on women.
Pearson says he's proud of Vermont for pushing back on this paradigm.
“This is a family decision in many cases, and we should not pretend that this burden only falls to women at all,” he said. “[It should] reflect the reality in that many, many cases, families make this decision together, and that’s appropriate."
Pearson said in Vermont's liberal bubble, people may not realize that access to birth control could be limited. “But we are also part of a national dialogue,” he added, "and it’s important for us to push in the right direction while we watch so many states try to undo this basic rights.”
However, not everyone in Vermont agrees that's the right direction.
In the legislative debate, the Diocese of Burlington argued for religious exemption before the House Health Care Committee.
“First Amendment, freedom of religion, how can you compel a religious organization to do something which it views as cooperation with evil?” says Pete Gummere, a bio-ethicist and deacon with the Diocese of Burlington. He's made a career of grappling with morality and modern medicine.
In a small room at Queen of Peace Church in Danville, Gummere says the Catholic Church regards sex and marriage as a complete package.
“It includes the procreative dimension of the marital act, and that is the potential for new human life to begin,” he said. “Separating those two by artificial means would be problematic.”
Gummere went on to confirm that "artificial" does include vasectomies.
For Gummere and the Catholic Church, the issue is not whether paying for health insurance is ethical, but that they “don’t want to pay for something that goes against our teachings."
In 2014, this was disputed in the Supreme Court decision Burwell v. Hobby Lobby. Ultimately, the Supreme Court ruled that corporations can claim religious exemptions from federal laws. However, this issue has not yet been disputed at the state level.
Vermont is the second state to codify the Birth Control Benefits outlined in the Affordable Care Act, after California in 2014.