Birth control coverage proposed for most health insurance plans

Virtually all health insurance plans could soon be required to offer female patients free coverage of prescription birth control, breast-pump rentals, counseling for domestic violence, and annual wellness exams and HIV tests as a result of recommendations released Tuesday by an independent advisory panel of health experts.

The health-care law adopted last year directed the Obama administration to draw up a list of preventive services for women that all new health plans must cover without deductibles or co-payments. While the guidelines suggested Tuesday by a committee of the National Academy of Sciences’ Institute of Medicine are not binding, the panel conducted its year-long review at the request of Health and Human Services Secretary Kathleen Sebelius.

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A medical advisory group recommended that insurance coverage pay for birth control as part of the nation's health care overhaul. (July 20)

A medical advisory group recommended that insurance coverage pay for birth control as part of the nation's health care overhaul. (July 20)

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In a statement, Sebelius praised the committee’s work as “historic” and “based on science and existing literature.”

“We are reviewing the report closely and will release the department’s recommendations . . . very soon,” she added.

Although generally expected, the committee’s decision to put “the full range” of Food and Drug Administration-approved contraceptives and sterilization procedures on its proposed list ignited immediate controversy.

Jeanne Monahan, director of the Center for Human Dignity at the socially conservative Family Research Council, said that many Americans may object to birth control on religious grounds. “They should not be forced to have to pay into insurance plans that violate their consciences. Their conscience rights should be protected,” she said.

Just as troubling, said Mona­han, was the inclusion of emergency contraceptives such as the so-called morning-after pill sold as Plan B and the more recently approved drug sold as Ella. Both primarily work by inhibiting ovaries from releasing eggs. But antiabortion advocates argue that there is evidence the drugs can also prevent an already-fertilized egg from implanting in the womb, which they consider equivalent to abortion.

Adam Sonfield, a public policy expert at the Guttmacher Institute, a nonprofit research center, countered that the scientific basis for such claims is highly questionable and that in any case, the medical field defines pregnancy as beginning with the implantation, not the fertilization, of an egg.

“They are purposely trying to confuse the American public about what contraception is and to try to tar it as abortion because . . . in truth they are not just antiabortion, they are anti-contraception,” he said. “And they know the American public overwhelmingly supports contraception.”

For instance, Sonfield said, a Guttmacher study found that 98 percent of sexually active Catholic women and nearly 100 percent of evangelicals have used contraception at some point, compared to 99 percent of women overall.

Other research by Guttmacher suggests that those with health insurance are already very likely to get some degree of birth-control coverage from their health plans. This is at least partly because of a recent surge in state laws mandating such coverage as well as a federal law that, since 2000, officials have interpreted to require employers to include contraception if they pay for other preventive services and prescription drugs. In 1998, Congress also added a birth-control coverage requirement to health plans for federal employees.

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