Last week, I wrote a deeply personal post about how the Patient Protection and Affordable Care Act will help me get much needed treatment for gallstones. I told a bit of my story and posed three basic questions for fiscal and social conservatives who oppose the ACA: 1.) Do they believe small business owners who don’t have access to affordable health insurance will be a drain on the economy? 2.) Do they think homemakers who re-enter the work force are undeserving of affordable health care? 3.) Does pro-life concern for mothers only extend to their utility as symbols for a cause?

The post generated a lot of reaction, both positive and negative. I appreciate all the responses because they tell me I tapped into something important. One criticism in particular stuck in my craw, though, so I’d like to respond to it. Then, I want to offer a challenge to institutions like Wheaton College, which cited religious freedom and sanctity of life concerns in its decision to file a lawsuit this week against the U.S. Department of Health and Human Services over the ACA contraception mandate.

What Does It Mean to Be Responsible for Oneself?

First, the criticism. Some accused me of wanting others to pay for the choices I’ve made in my life. This is not only an affront to everything I believe, but it is patently false. From the time I chose not to abort my child, I’ve taken responsibility for my actions. In a 2004 Christianity Today essay about my unplanned pregnancy, for example, I wrote the following words:

“I have always seen the decision not to terminate my pregnancy as the one courageous moment of my life. I acted with self-abandon for the benefit of the innocent. But lately, I’ve begun to think it curious that I should have seen not killing my own child as heroic. I could spin a sad tale to make myself look better, but the fact is I failed in my duty to my family, my community, and my Savior. Accepting the consequences of that failure was not heroism. Only in a culture where sex is divorced from meaning and where self-interest trumps everything could such a narrative be produced. Courage would have been to decline that offer of illicit comfort in the first place.”

I still believe this.

Likewise, when my husband and I decided that I would stay home with our children, it was, in part, an economic decision. It didn’t make financial sense for me to get a job and devote a large chunk of my income to childcare and other work-related expenses, so long before he was earning a six-figure income, we chose to live frugally on one income, at least until our children were in school. I either worked part-time or went to school part-time for much of the time that I “stayed home.” I also home-schooled our sons for several years because our urban district had some typical urban school problems that we judged not to be good for our children. If that was not taking responsibility for myself and my family, I don’t know what is.

I could go on and detail the myriad ways my husband and I have continued to be responsible citizens in the decade since he left his high-paying job, but I’ll simply say that when I was in the midst of any of the four gallbladder attacks I’ve had in the past two weeks, it would have been easy for me to go to the emergency room and not worry about who pays the bill, as I imagine some uninsured Americans do. But I am not one of those people. What I’ve been trying to do instead is to find a way to keep doing what I’ve always tried to do, which is to live my life with integrity. So, I sent in my application for NJ Protect last week, along with a check for $584, which is what a decent plan will cost me every month, and made an appointment with a gastroenterologist for August 2, when I will be insured again. My family will resume paying in the neighborhood of $1000-a-month for mediocre health insurance. How anyone can view this as me wanting someone else to pay my way is beyond me.

The History and Reality of Employer Sponsored Health Insurance

In 2005, the non-partisan Urban-Brookings Tax Policy Center reported that “health insurance provided by employers is a tax-free fringe benefit that costs the government over $140 billion annually.” The report said employer-sponsored insurance covers almost two-thirds of workers and their families, but “overwhelmingly favors” the middle and upper classes. That was seven years ago. I’d guess fewer workers are covered by ESI now.

In a 2006 New England Journal of Medicine article, Dr. David Blumenthal described our system of employer-sponsored insurance as “an accident of history that evolved in an unplanned way and, in the view of some, without the benefit of intelligent design.” He said President Franklin D. Roosevelt chose not to advance universal health insurance as a part of Social Security because of “fierce opposition from the American Medical Association,” which was “a much more potent lobby then than it is now.” As it happens, Roosevelt had lunch with his father-in-law, an influential neurosurgeon who opposed the plan, just before deciding not to push for universal health insurance.

Private insurance emerged to fill the gap and then a series of federal laws cemented the ESI system into place. During World War II, because of inflation concerns, the federal government “limited employers’ freedom to raise wages,” but allowed them to expand benefits like health insurance so that they could compete for scarce workers, Blumenthal said. Then, in 1954, the IRS “decided that the contributions that employers made to the purchase of health insurance for their employees were not taxable as income to workers.” By 2004, the tax benefit for every American with ESI was about $1,180, he said.

Many would argue that a tax break is not the same thing as a subsidy, but it bears noting that workers who have ESI already get a break that the uninsured do not get, and the decisions that led to this break were political, and perhaps even personal, if it’s true that Roosevelt’s father-in-law influenced his decision to not push for universal health insurance.

What Does It mean to be Responsible for One’s Rhetoric?

Now, onto my challenge. In my previous post, I said that vocal pro-lifers seem to care more about the contraception mandate than they do about the long-term well being of women who don’t abort their children. This week, in a highly unusual step, Wheaton College, in Wheaton, Illinois, announced that it is joining other Christian colleges in suing the Department of Health and Human Services over the mandate, in part because it will require Wheaton’s employee health insurance plan to cover abortifacient drugs commonly known as “morning after” and “week after” pills. These schools have every right to do this, but I’d like to challenge them to adopt a more consistent pro-life policy, like the one my uncle Charlie Gifford pushed to have enacted when he was associate dean and campus pastor at Taylor University in Upland, Indiana.

I talked to my uncle this morning. He said that when a freshman at the school came to him and told him she was pregnant, he questioned Taylor’s policy of suspending unmarried pregnant students until after the births of their babies. He also questioned why fathers were not similarly disciplined. As a result, Taylor changed its policy. The school no longer suspends unmarried pregnant students, but it does require them and the male students who impregnate them to live in approved off-campus housing during the third trimester of pregnancy. My uncle did more. He and my aunt welcomed two pregnant Taylor students into their home so that these women could continue their educations. Both women gave their babies up for adoption, he said, and their parents are among the most loyal supporters of his current ministry in Sheridan, Wyoming.

When my late son Gabe was a student at Wheaton College, I asked the dean of women what the school’s policy was on pregnant unmarried students. She said Wheaton had to do what was in the best interest of the whole community, which I took to mean that it suspended or expelled unmarried pregnant women, just as I would have been suspended or expelled when I became pregnant at Eastern Mennonite University in Harrisonburg, Virginia, if I hadn’t already left the school. Wheaton’s current policy, which its communications director LaTonya Taylor sent via email late this afternoon, says the school is prepared to “stand with” both the mother and the father, but in practical terms it is vague, saying only that on-campus residency and/or enrollment “will be considered in light of what is best for all those involved.”

So, I’ll conclude by saying that if Christian colleges want to take a strong pro-life stand, they need to be consistent and do a better job of supporting women who become pregnant on their campuses. Allowing pregnant women to continue with their studies is not synonymous with condoning extra-marital sex. “Grace and mercy is a scandal. It always is,” my Uncle Charlie told me this morning. How about let’s all be scandalized for the right reasons for a change? Wouldn’t that be refreshing?

Update 7/27: Wheaton College emailed the following clarification regarding its policy:

“Under the current policy, which has been Wheaton’s policy since 2001, the College has allowed pregnant female students—as well as the fathers of their children, if they are also enrolled—to continue their studies before and/or after the births of their babies. Students are not automatically suspended or expelled for becoming pregnant while unmarried. The challenge to community life is largely related to providing appropriate housing for an expectant mother and newborn, given the realities of residence hall life. Our practice has been to assist young women in finding off-campus housing during the final months of pregnancy. The living situation following the pregnancy is, of course, dependent on many factors—most of them related to the new parents’ decisions about marriage, adoption, or single parenthood. Our goal and practice for expectant students is to provide spiritual support and practical assistance in arranging appropriate housing, adjusting to their new reality, making decisions, and completing their studies.”