New Preventive Services Guidelines Released, Groups Still Await Regulations On Contraception

BirthControlToday, the administration is unveiling the preventive services insurers will be required to cover with no co-pays or out-of-pocket costs beginning September 23. “Cancer screenings, including mammograms and colonoscopies, as well as obesity prevention services, immunizations, blood pressure screenings and tobacco cessation services are among those that will be available” at no extra charge, the Wall Street Journal reports. Sen. Jon Kyl (R-AZ) took credit for this provision on Monday and Republicans seem to agree that identifying diseases before they become chronic is a smart way to reduce health care spending over the long term.

But as Dana Goldstein pointed out yesterday, many Republicans don’t think the same is true for family planning services, which could also be available at no additional charge. Regulations for women-specific preventive services — the result of Sen. Barbara Mikulski’s (D-MD) amendment — are expected to be issued in the near future, but Republicans are already laying the groundwork for opposition. From Goldstein’s piece:

The conservative groups are particularly worried that a birth control coverage mandate could include teenage girls and young women covered under their parents’ health insurance plans. “People who are insured don’t want to pay for services they don’t need or to which they have moral objections,” said Chuck Donovan, senior researcher at the Heritage Foundation. “Parents want to have a say over what’s covered and what’s not for their children.” […]

“I don’t want to overstate or understate our level of concern,” said McQuade, the Catholic bishops’ spokesperson. “We consider [birth control] an elective drug. Married women can practice periodic abstinence. Other women can abstain altogether. Not having sex doesn’t make you sick.”

Planed Parenthood and other health organizations are lobbying HHS to include birth control and other family planning provisions in the category of cost-exempt preventive services, noting that increasing co-payments often put birth control out of reach for lower income women. “Average copayments in employer-sponsored insurance have increased considerably over the past decade, to as much as $46 in 2009 for many brand-name drugs,” one study showed.

Investments in affordable contraception leads to better health outcomes and overall cost savings. As the Guttmacher Institute notes, “every $1 invested in public dollars for contraception saves $3.74 in Medicaid expenditures that otherwise would have been needed to provide pregnancy-related care (prenatal, labor, delivery and postpartum care) for women’s unintended births, as well as one year of medical care for their infants.” And medically, “unintended pregnancies are serious in terms of the lost opportunity to prepare for an optimal pregnancy, the increased likelihood of infant and maternal illness, and the likelihood of abortion.” “The mother is less likely to seek prenatal care in the first trimester and more likely not to obtain prenatal care at all. She is less likely to breastfeed and more likely to expose the fetus to harmful substances, such as tobacco or alcohol. The child of such a pregnancy is at greater risk of low birth weight, dying in its first year, being abused, and not receiving sufficient resources for healthy development.”

Guttmacher estimates that publicly funded contraceptive services and supplies alone help women in the United States avoid nearly 2 million unintended pregnancies each year.