Free birth control, including the controversial "morning-after" pill, could soon be added to a list of services insurers must fully cover under President Obama's health care law.
A nonpartisan Institute of Medicine panel recommended Tuesday that contraception and a handful of other services related to women's health be considered preventative and must be covered by insurance companies without charging co-payments. Screening for the virus that causes cervical cancer and diabetes tests during pregnancy were among the non-binding suggestions sent to the Department of Health and Human Services.
President Obama's 2009 health care overhaul law already requires insurers to provide standard preventative care for consumers at no extra charge. While HHS has already outlined most of the qualifying services, the women's health recommendations were considered so sensitive that the independent, nonpartisan institute was asked to look at the issue and report its findings.
Panel members identified services they consider necessary for the health and well-being of women, without taking cost into consideration.
They recommended including all FDA-approved emergency contraceptions, including Plan B, the so-called "morning-after pill," but not RU-486, a more controversial pill that induces abortions.
HHS Secretary Kathleen Sebelius is expected to announce by Aug. 1 which recommendations will be adopted.
But the recommendations could still face a still fight. Planned Parenthood, the nation's largest provider of family planning and abortion services, praised the proposals, but anti-abortion groups were critical.
The conservative Family Research Council said including the morning-after pill in the insurance guidelines "essentially would mandate coverage for abortion."
"If HHS includes these mandates, the conscience rights of millions of Americans will be violated," Jeanne Monahan, the director of the councils Center for Human Dignity, said in a statement. "HHS should focus on items and services that prevent actual diseases, and not include controversial services just to placate the abortion industry."
Other services recommended by the panel for coverage include counseling on sexually transmitted infections; screening for HIV; equipment and counseling to promote breast-feeding; screening for domestic violence; and annual preventative care check-ups for women.
Dr. Linda Rosenstock, dean of the UCLA School of Public Health, said testing for the HPV virus should be paired with annual Pap smears, adding that coupling the tests provides an "effective screening mechanism" for cervical cancer. While women are encouraged to get annual Pap smears, regular testing for HPV is a relatively new medical practice.
"We feel the evidence is quite good to recommend that should the clinician and patient decide it be appropriate, coverage be provided," Dr. Rosenstock said.
Dr. Rosenstock said the panel recommended routine HIV testing because many women don't realize they're at risk.
"Unfortunately, a larger proportion over time of women at risk are women themselves who are not engaging in risky behavior, but their male heterosexual partners are engaging in risky behavior," she said.
Sen. Barbara A. Mikulski, Maryland Democrat, who introduced the amendment requiring all health plans to cover women's preventative care, applauded the recommendations.
"We are one step closer to saying goodbye to an era when simply being a woman is treated as a pre-existing condition," Ms. Mikulski said. "We are saying hello to an era where decisions about preventative care and screenings are made by a woman and her doctor — not by an insurance company."
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