A key provision in the health care reform act mandates that women have free access to preventive care. And that's setting off a debate on whether birth control constitutes preventive care. The AP reports that Democratic senator Barbara Mikulski, who championed the inclusion of the women's care amendment in the bill, clearly intended that family planning fall under the rubric of preventive care that all private health insurers will be required to provide.
But the final call on that is now in the hands of the Department of Health and Human Services, which has the fun job of converting the broad brushstrokes of the legislation Congress passed into actual policy.
In the AP report a leading family planning expert characterized contraception as "a prototype of preventive medicine" but HHS has convened its own panel of experts to sit down later this month and bat around the issue. The final ruling on what coverage will be required should be handed down no later than August 1, 2011. Given the imminent return of Republican control of at least the House after tomorrow's mid-term elections, this could get interesting. Here are a few points to consider:
Republicans are already hungry to undo health care reform. It's no secret that Republican members of Congress have stated their desire to undo health care reform, or muck up as much of it as they can. And contraception has some recent history as a divisive issue on the Hill. Back in early 2009, the Republicans shot down a Democratic proposal to include more Medicaid funding for family planning in the economic stimulus bill. Granted, the bone of contention then was how that spending would help job creation. John Boehner, the heir apparent to be Speaker of the House following tomorrow's elections, said back in January 2009: "How you can spend hundreds of millions of dollars on contraceptives? How does that stimulate the economy?" Stay tuned on whether the Boehner-led House will take up the issue of having private insurers provide free birth control.
Republican women? Not so much. If the Republicans are interested in serving their constituency, they might not put up that fight. According to a national poll conducted for Planned Parenthood, 72 percent of Republican women say birth control should indeed be fully covered as part of the preventive care initiative.
Cost is an issue. In the same poll, only about one-third of women overall said that the cost of birth control had made it difficult to consistently use prescription birth control at some point in their lives. But among young women age 18-34 -- the actual group most likely to need birth control -- 55 percent said cost was an issue.
If birth control is included as preventive care, it will be 100 percent covered; no co-insurance or co-pays will be required. Given the ever-spiraling cost of health insurance -- and the fact that employees are being required to cover more and more of the cost -- access to free birth control would be a nice, albeit small, way for some households to reduce their expenses.