Still, none of these mandates require plans to cover contraception without co-pays or other forms of cost-sharing. And there is evidence that the out-of-pocket cost may discourage many women from using birth control as consistently as they would like: About half of all pregnancies are unplanned, according to Guttmacher.
The rules on preventive services for women complement a broader provision in the new health-care law that already requires plans to offer free preventive care for men, women and children from lists drafted by other panels of independent scientific experts, most prominently the U.S. Preventive Services Task Force.
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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)
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However, because that task force has historically paid less attention to gender-specific recommendations, the law’s drafters added a requirement that the Department of Health and Human Services issue a supplementary list for women.
Women’s health advocates pronounced themselves delighted that the Institute of Medicine committee had chosen to recommend not only the widest possible range of contraceptive services but also an expansive spectrum of other preventive services.
These include screening for gestational diabetes in pregnant women; more sophisticated testing for a virus, known as HPV, that is associated with cervical cancer; annual counseling for sexually active women on sexually transmitted infections; and multiple visits to obtain preventive services if they cannot be provided in one annual exam.
“We’re very pleased about the scope of these recommendations,” said Judy Waxman of the National Women’s Law Center. “Assuming HHS adopts them I expect a big impact on women’s health.”
Insurers will need to follow the new guidelines at the start of the next plan year within one year after Sebelius issues them.
The administration estimates that 41 million Americans are in “new” employer or individual plans to which the rules will apply. An additional 98 million people are covered by “grandfathered” policies exempt from the new rules. But such plans can lose grandfathered status if they make a host of changes to their coverage and payment policies. So their number is expected to dwindle rapidly in coming years, such that by 2013, 47 million more Americans will be in employer plans covered by the new rules.
The guidelines will also largely apply to plans covering federal employees, but not to Medicare, Medicaid or TriCare. Medicaid and TriCare already offer contraceptive coverage, with Medicaid offering it at no cost.
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