Updated 6 p.m. ET | In just one year, the price tag for birth control, yearly check-ups, breastfeeding support and domestic-violence screening will virtually disappear for many American women.
Under new guidelines issued Monday by the Department of Health and Human Services, eight preventive health services will no longer require co-pays and deductibles. The new rules will take effect for all new insurance plans starting Aug. 1, 2012, and will apply to much of the population by the start of 2013.
Despite a firestorm of criticism from conservative and religious groups, the guidelines include full coverage of all FDA-approved contraception methods. That includes Plan B — the so-called “morning-after pill” — which some consider to be a form of abortion.
Also included are screening for gestational diabetes, testing for human papillomavirus (HPV) for women 30 years and older, counseling for sexually transmitted infections, and HIV screening and counseling.
The health care reform law requires insurance providers to cover 100 percent of the costs for all preventive health care services HHS officials deem essential. The eight new services join a growing list already embedded in the law, including colonoscopies, mammograms, pediatric services, and vaccinations.
HHS Secretary Kathleen Sebelius noted that her decision was “based on science and existing literature” and came at the recommendation of the nonpartisan Institute of Medicine on July 19. Partially due to the highly charged debate surrounding birth control, HHS asked the independent agency to identify “gaps” in existing preventive services covered under the law – particularly for diseases and conditions that might require specific interventions for women.
Speaking to reporters Monday afternoon, Sebelius said the medical community has long known “this kind of care can prevent illness and improve health, but for too long, too many Americans have gone without it, in many cases because it cost too much.” The guidelines are meant to eliminate the barrier so that no woman in America “has to choose between paying a grocery bill and paying the co-pay for preventive care that can save her life,” she said.
While HHS gave blanket approval to all eight of the Institute of Medicine recommendations, the agency also released an amendment that will allow religious institutions that offer insurance to their employees the choice to opt out of covering contraceptive services. According to agency officials, the regulation is modeled on the most common accommodation for churches available in most of the 28 states that already require insurance companies to cover contraception.
Women’s rights groups heralded the general announcement as a game-changer of historic proportions. Debra L. Ness, president of National Partnership for Women & Families, wrote about “a new era for women’s health.” Planned Parenthood Federation of America president Cecile Richards, said it was “monumental for millions of women who have struggled with the cost of birth control and other essential health-care services such as cervical cancer and HIV screening.”
But both groups expressed disappointment with the decision to exempt religious employers from the contraception rule. Pointing to a 2011 Guttmacher report, Planned Parenthood noted that among all women who have had sex, 99 percent used contraception. Even among Catholic women, 98 percent have done the same. Sixty-eight percent of Catholic women and 74 percent of evangelicals used a “highly effective method,” such as the pill or IUD.
For their part, conservative and religious groups say the new rules go entirely too far.
Cardinal Daniel N. DiNardo, archbishop of Galveston-Houston and chairman of the U.S. Conference of Catholic Bishops’ Committee on Pro-Life Activities, issued a statement Monday decrying the use of federal funds for the subsidy of “abortion” drugs and questioning the rationale for the general contraception mandate.
“HHS says the intent of its ‘preventive services’ mandate is to help ‘stop health problems before they start,'” he said. “But pregnancy is not a disease, and children are not a ‘health problem’ – they are the next generation of Americans.”
Jeanne Monahan, Director of the conservative Family Research Council’s Center for Human Dignity, issued a statement calling the amendment little more than a “fig leaf of conscience protection.”
“The new rule will force many Americans to violate their consciences or refrain from participating in health care insurance, further burdening an already costly system,” she said. Among the religious groups “not protected from any discrimination whatever,” Monahan pointed to those that provide social services, engage in mission work to people of different religious faiths, religious health insurance companies, and religious health care providers.
Other critics say the main concern is an economic one. Continuously making insurance companies fit the bill for an ever-increasing list of preventive services will drive up premiums.
But Sebelius argues that denying women relatively cheap preventive services because they can’t afford the co-pay is one of the culprits behind the nation’s ever-expanding health costs – “driving up health care bills for families and businesses by “allowing small health concerns to grow into big ones.” Eliminating the financial barrier will help reduce costs for everyone in the long run, she said.