Should you have to pay for other people's birth control?
Some women have long wondered why Viagra is covered by most private insurance plans, but birth control pills aren't. Well, change may be coming soon: This week, the non-partisan Institute of Medicine recommended that health insurers reclassify women's contraceptives as "preventive care" and cover them without requiring a co-payment under the Affordable Care Act.
The report, commissioned by the Department of Health and Human Services, was intended to provide "a road map for improving the health and well-being of women," committee chair Linda Rosenstock, dean of the School of Public Health at the University of California, Los Angeles, said in a statement. "The eight services we identified are necessary to support women's optimal health and well-being. Each recommendation stands on a foundation of evidence supporting its effectiveness."
The report also recommends HIV screening, counseling on sexually-transmitted infections, screening for gestational diabetes, support for breast-feeding mothers, yearly preventive care visits, counseling and prevention of domestic violence, and counseling to prevent unintended pregnancies.
"Women with unintended pregnancies are more likely to receive delayed or no prenatal care and to smoke, consume alcohol, be depressed, and experience domestic violence during pregnancy," the report reads. "Unintended pregnancy also increases the risk of babies being born preterm or at a low birth weight, both of which raise their chances of health and developmental problems."
Reactions to the Institute of Medicine's announcement were clearly-and predictably-divided.
"One of the great promises of the new health care law is the potential for prescription birth control to be covered with no co-pays," Cecile Richards, president of Planned Parenthood Federation of America, said in a statement. "Making birth control available with no co-pays will significantly increase access to birth control for millions more women and help reduce the high number of unintended pregnancies in this country. We know that reducing unintended pregnancies in this country leads to positive health outcomes for women and children. It leads to healthier births, a lower infant mortality rate, and better women's health overall."
"Half of all pregnancies that happen in the U.S. every year are unintended," Dr. Deborah Nucatola, an OB-GYN who is the senior director for medical services for Planned Parenthood, told NPR. "And if we could prevent an epidemic of this proportion, that should be justification enough that contraception is preventive care."
But the others disagreed. Deirdre McQuade, spokesperson for the Secretariat of Pro-Life Activities of the United States Conference of Catholic Bishops, issued a statement saying: "The Conference has a particular concern that contraceptives and sterilization not be mandated as 'preventive' services. To prevent pregnancy is not to prevent a disease... In addition, contraceptives and sterilization are morally problematic for many stakeholders, including religiously-affiliated health care providers and insurers."
The Family Research Council also opposed the Institute of Medicine's recommendation about birth control, saying that having insurance companies cover any contraceptive was tantamount to forcing taxpayers to pay for other people's abortions.
"By their very nature, contraceptive services are elective and not medically necessary. They should not be placed in the same category as other basic types of medical care," Jeanne Monahan, director of Family Research Council's Center for Human Dignity, said in a statement. "Any mandates on abortion coverage would expand taxpayer funding for abortion, and inclusion of contraceptives would undermine conscience protections that President Obama promised would be maintained."
"We want people who have conscience issues to not be forced into a mandate that covers these drugs," Monahan clarified in an interview with the National Journal.
But, as Erin Gloria Ryan points out over at Jezebel, easily accessible, reliable birth control would reduce the number of abortions in America, not increase them. Also: Being morally opposed to something the government subsidize (in Ryan's case, "both the war in Afghanistan and paying for Dick Cheney's steampunk heart") doesn't give people the right to refuse to pay for it via their taxes. People aren't currently allowed to opt out of paying for programs with which they disagree. Why should this particular aspect of health care be any different?
What do you think? Should birth control be completely covered by insurance, without a co-payment? Or is it wrong to make everyone pay for an option that not everyone uses?
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