Feature Story - September 2011
Contraceptives on Track to Being Free Under Health Care Reform Law
All forms of birth control approved by the Food and Drug Administration would be covered by the policy, including "emergency contraceptives" also known as the "morning-after" pill, marketed under the names of Ella and Plan B.
The U.S. Department of Health and Human Services is in the midst of a 60-day comment period that concludes at month's end, on plans to expand, under President Obama's Patient Protection and Affordable Care Act of 2010, coverage of so-called "preventative" services for women, at no cost to the patient.
The most contentious regulation will require new health insurance companies, not existing, grandfathered providers, to cover contraception without charging a co-payment, co-insurance, or a deductible, with plan years beginning on or after August 1, 2012.
Co-pays for birth control pills typically range between $15 and $50 per month.
The HHS guidelines follow recent recommendations made by the independent Institute of Medicine, a branch of the National Academy of Sciences.
In making the announcement, HHS Secretary Kathleen Sebelius said, "The Affordable Care Act helps stop health problems before they start. These historic guidelines are based on science and existing literature, and will help ensure women get the preventive health benefits they need."
HHS estimates that 34 million women, ages 18 to 64, will be covered under new health insurance plans by 2013.
The American Civil Liberties Union hailed the impending new guidelines by HHS.
Laura Murphy, director of the ACLU's Washington Legislative Office, stated, "Contraception is basic health care for women. This landmark decision means affordable, effective contraception will no longer be out of reach for millions of women. Secretary Sebelius is acting in the best interests of American women, counteracting discriminatory practices denying women access to essential health care."
Likewise, Dr. Vanessa Cullins, vice president for medical affairs at Planned Parenthood Federation of America, said, "There is no doubt that birth control is basic health care for women. Covering birth control without co-pays is one of the most important steps we can take to prevent unintended pregnancy and keep women and children healthy."
Some in the faith community also praised the new HHS regulations on contraception.
The Rev. Carlton Veazy, president and CEO of the Religious Coalition for Reproductive Choice, said, "The Obama administration's decision to expand insurance coverage for contraception is a significant step forward in creating a more just and compassionate society, in which fostering the health of women and children is a basic commitment. The decision by the Department of Health and Human Services directs new health plans under the health reform law to cover FDA-approved contraceptives without burdening women with out-of-pocket fees.
This is a historic decision, removing a significant barrier to women–particularly women who are disadvantaged by low-income or lack of access to health care–having the means to make decisions about having and timing children. Reducing cost barriers to contraception will greatly benefit women who might otherwise not be able to access these critical services. The ability to plan pregnancies is so important that RCRC considers it a moral value. Diverse religions recognize that family planning helps to build strong families, protect the health of women and children, reduce child and spousal abuse, and prevent unwanted pregnancies and reduce the need for abortion," Veazy said.
Linda Bales, staff executive of the United Methodist Church General Board of Church and Society, said, "The United Methodist Church has an historic, strong stance in support of women's health and family. Ensuring that affordable options are available under insurance plans, as the IOM suggests, would go a long way to helping individuals meet those obligations."
Jon O'Brien, president of Catholics for Choice, stated, "Polling shows that more than 60 percent of Catholics support health insurance coverage–whether it is private or government insurance–for family planning. Catholics have a responsibility to listen to our consciences in matters of moral decision-making, and to respect other people's right to do the same. Removing unnecessary obstacles, as this report recommends, means that more women will have the means to follow their own consciences in deciding whether and when to have children."
However, the Catholic Church is staunchly opposed to the new regulations.
Cardinal Daniel DiNardo, chairman of the Committee on Pro-Life Activities of the United States Conference of Catholic Bishops, asserted, "Pregnancy is not a disease, and fertility is not a pathological condition to be suppressed by any means technically possible. I can only conclude that there is an ideology at work in these recommendations that goes beyond any objective assessment of the health needs of women and children."
Presently, 17 of the 28 states that require contraception coverage have some sort of religious exemption in place for employers.
HHS also released an amendment along with the new regulations that allows religious institutions that offer health insurance to their employees, the choice of whether or not to cover contraception services.
However, the exemption applies only to an organization that: "(1) has the inculcation of religious values as its purpose; (2) primarily employs persons who share its religious tenets; (3) primarily serves persons who share its religious tenets: and (4) is a nonprofit organization" as specified by the Internal Revenue Service Code.
DiNardo said the religious exemption is too narrow in scope.
"Our institutions would be free to act in accord with Catholic teaching on life and procreation only if they were to stop hiring and serving non-Catholics. Could the federal government possibly intend to pressure Catholic institutions to cease providing health care, education and charitable services to the general public? Health care reform should expand access to basic health care for all, not undermine that goal," DiNardo noted.
The cardinal's concerns were echoed by Jeanne Monahan, director of Family Research Council's Center for Human Dignity.
"HHS offered a fig leaf of conscience protection for certain churches that fulfill very specific criteria. However, religious groups that provide social services, engage in missions work to people of different religious faiths, religious health insurance companies, let alone religious health care providers and individuals in such health plans are not protected from any discrimination whatever. 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.
The mandate will include FDA-approved drugs like Ella and Plan B that are misleadingly labeled ‘emergency contraceptives' despite the fact that they can actually destroy a developing baby prior to or after implanting in the mother's womb. HHS failed to address this problem in the interim rule, despite many public comments on this very issue.
For an administration that promised to protect conscience laws in effect now, this decision completely ignores opinion, research and science that do not support a pro-abortion ideology. In the words of one of the committee members who objected to the IOM recommendations, the ‘evaluation for evidence lacked transparency...the process tended to result in a mix of objective and subjective determination through the lens of advocacy.'
This administration is promoting mandates that will violate the consciences of millions. Therefore, FRC urges Congress to pass the bi-partisan ‘Respect for Rights of Conscience Act of 2011,' sponsored by Reps. Jeff Fortenberry (R-NE) and Dan Boren (D-OK), which would protect the conscience rights of those who object to being forced to cover, provide or pay for such drugs," Monahan said.
The bill, in part, reads, "Amends the Patient Protection and Affordable Care Act to permit a health plan to decline coverage of specific items and services that are contrary to the religious beliefs of the sponsor, issuer, or other entity offering the plan or the purchaser or beneficiary (in the case of individual coverage) without penalty. Declares that such plans are still considered to: (1) be providing the essential benefits package or preventive health services, (2) be a qualified health plan, and (3) have fulfilled other requirements under PPACA.
Prohibits an American Health Benefit Exchange (a state health insurance exchange) or other official or entity acting in a government capacity in the course of implementing PPACA from discriminating against a health plan, plan sponsor, health care provider or other person because of an unwillingness to provide coverage of, participate in, or refer for, specific items or services.
Designates the Office for Civil Rights of the Department of Health and Human Services to receive and investigate complaints of discrimination based on this Act."
DiNardo also urged passage of the legislation.
"It's now more vital than ever that Congress pass the Respect for Rights of Conscience Act to close the gaps in conscience protection in the new health care reform act, so employers and employees alike will have the freedom to choose health plans in accordance with their deeply held moral and religious beliefs."
The measure is also backed by the 16-thousand member Christian Medical and Dental Associations, which issued a statement, that read, in part, "Millions of patients, notably the poor and those in medically underserved regions, depend for care on religious healthcare institutions and professionals whose faith and conscience compel their service. Apart from protection for conscience, nine of ten faith-based physicians say they would be forced to leave medicine. Yet the Obama administration eviscerated the only federal regulation that protected the exercise of conscience in health care, and partisans in the last Congress shot down amendments to protect conscience in Obamacare.
This administration's allegiance to the abortion lobby and persistent attacks on conscience freedoms calls for legislative action," the CMDA stated.
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