Insurance companies must fully cover contraception, HIV and HPV screening and a handful of other women’s health services under new guidelines released Monday by the Obama administration.
Insurers may not charge a co-payment or deductible or require co-insurance for any of the preventative measures outlined by an Institute of Medicine (IOM) panel charged with identifying services considered necessary for the health and well-being of women.
The administration chose to adopt all of the panel’s recommendations from a nonpartisan, adding them to the list of preventative services insurance companies must now cover at no extra charge under President Obama’s health care bill, the 2010 Affordable Care Act.
“Under the law, we’re making it illegal for insurers to charge women more just because of their gender,” said Secretary of Health and Human Services Kathleen Sebelius.
Insurers must cover all FDA-approved emergency contraception, including Plan B, the so-called “morning-after pill,” but not RU-486, a more controversial pill that induces abortion. While some of those drugs are available over the counter, a woman would have to show a prescription from her health care provider to be guaranteed them free of charge.
For religious institutions opposed to some varieties of birth control, the administration added an exemption that allows them to opt out of the coverage requirement. To qualify, an organization must have religious employees and promote religious causes.
Groups on both sides of the abortion debate complained about the opt-out, which was patterned after similar exemptions offered in the majority of 28 states that already require insurers to cover contraceptives.
Judy Waxman, vice president for health and reproductive rights at the National Women’s Law Center, said that while the mandates are “a step forward” for women’s health, she thinks adding the religious exemption was “unfortunate.”
She cited widely circulated findings from the Guttmacher Institute of high contraception usage rates among Catholic and evangelical women.
“Women of every religion use contraception to about the same degree as other women. … I think all women should have access to these services,” Ms. Waxman said.
But Jeanne Monahan, director of the Family Research Council’s Center for Human Dignity, called the exemption a “fig leaf of conscience protection,” saying it would not extend to para-church organizations and religious health providers or insurance companies.
“The new rule will force many Americans to violate their consciences or refrain from participating in health care insurance, further burdening an already costly system,” she said.
Going into effect August 1, 2012, the mandatory guidelines also include annual preventative care checkups for women, screening for gestational diabetes, counseling on sexually-transmitted infections, breastfeeding support and domestic violence screening and counseling. Previously existing plans, protected under a “grandfather” clause in the ACA, will be exempted from the mandates but could eventually face pressure to include them.
The new federal mandates will impact states differently, depending on whether they already impose coverage mandates in insurance companies. HHS officials said they expect the coverage to affect tens of millions of women.
The administration had already outlined most of the services qualifying as preventative care under the ACA, which include mammograms, colonoscopies, blood-pressure checks and childhood immunizations. But the women’s health recommendations were considered so sensitive that the IOM was asked to look at the issue. The panel reported its findings last month.
Rep. Louise McIntosh Slaughter, New York Democrat and co-chairwoman of the pro-choice caucus, applauded the mandates.
“For years, we’ve fought to get contraception covered for women by health insurance, just as they have covered Viagra for men,” she said.