Coverage with no copay extended to birth control
Ricardo Alonso-Zaldivar | 8/2/2011, 11:29 p.m.
In a nod to social and religious conservatives, the rules issued Monday by Sebelius include a provision that would allow religious institutions to opt out of offering birth control coverage. However, many conservatives are supporting legislation by Rep. Jeff Fortenberry, R-Neb., that would codify a range of exceptions to the new health care law on religious and conscience grounds.
“It’s a step in the right direction, but it’s not enough,” said Jeanne Monahan, a policy expert for the conservative Family Research Council. As it now stands, the conscience clause offers only a “fig leaf” of protection, she added, because it may not cover all faith-based organizations.
Although the new women’s preventive services will be free of any additional charge to patients, somebody will have to pay. The cost will be spread among other people with health insurance, resulting in slightly higher premiums. That may be offset to some degree with savings from diseases prevented, or pregnancies that are planned to minimize any potential ill effects to the mother and baby.
The administration did allow insurers some leeway in determining what they will cover. For example, health plans will be able to charge copays for branded drugs in cases where a generic version is just as effective and safe for the patient.
The requirement applies to all forms of birth control approved by the Food and Drug Administration. That includes the pill, intrauterine devices, the so-called morning-after pill, and newer forms of long-acting implantable hormonal contraceptives that are becoming widely used in the rest of the industrialized world.
Coverage with no copays for the morning-after pill is likely to become the most controversial part of the change. The FDA classifies Plan B and Ella as birth control, but some religious conservatives see the morning-after drugs as abortion drugs. The rules HHS issued Monday do not require coverage of RU-486 and other drugs to chemically induce an abortion.
Other preventive services covered include:
- At least one “well-woman” preventive care visit annually.
- Screening for diabetes during pregnancy.
- Screening for the virus that causes cervical cancer for women 30 and older.
- Annual HIV counseling and screening for sexually active women.
- Screening for and counseling about domestic violence.
- Annual counseling on sexually transmitted infections for sexually active women.
- Support for breast feeding mothers, including the cost of renting pumps.
Aside from the conscience clause, the only other major exemption is for so-called “grandfathered” plans, many of which are offered by large employers. With time, however, many currently grandfathered plans are likely to lose that designation as they make routine changes affecting their benefits. Consumers should check with their health insurance plan administrator.