If birth control is preventive medicine, insurers must cover all costs


Birth control is a controversial issue. And I don't mean because of the political and religious arguments it can provoke. I'm talking about whether birth control and other contraceptives should be considered preventive medicine. 

HHS will issue new guidelines for women's preventive healthcare within the next year. Under the health reform law, services and medications defined as "preventive" must be offered to customers of new insurance plans free of co-pays. Meanwhile, HHS has charged the Institute of Medicine to examine the evidence and recommend whether contraception should be included in the list of health services that count as "preventive care."

That's where the situation gets a tad adversarial. Organizations like Planned Parenthood and the American Congress of Obstetricians and Gynecologists want it covered; groups including the U.S. Conference of Catholic Bishops and the Heritage Foundation don't. But what about insurers? Does it benefit them to provide full coverage for contraceptives?

Studies have consistently demonstrated that contraception is a safe and cost-effective way to reduce the estimated three million pregnancies a year that are unplanned, thereby decreasing associated costs like abortion and pre-natal care as well as other preventable health problems affecting both women and children. Reimbursing women for the cost of birth control is much cheaper than paying for the consequences, experts say.

Even among insured women, copays or deductibles, ranging from $20 to $50 per month for birth control pills to several hundred dollars for longer-acting methods, can discourage them from seeking preventive healthcare.

Among other health benefits, women who plan their pregnancies are more likely to get necessary prenatal care and avoid closely spaced births, which can put a strain on their bodies and their parenting skills, and may result in low-birth-weight babies. Further, experts estimate that full coverage of contraceptives in large plans would amount to between $16 and $40 per member annually.

The other side of the discussion revolves primarily around the question of fertility as disease. The Conference of Catholic Bishops says that allowing contraception to be covered as preventive medicine is tantamount to calling pregnancy a disease condition because many of the other services covered are related to disease prevention, such as colorectal and HIV screenings.  

While there are certainly many more factors at play in this argument, I tend to side with the camp believing that birth control and other contraceptives are indeed preventive care. And I'm most assuredly supportive of insurers covering preventive care because I believe that is the future of healthcare--and a huge opportunity to decreasing insurers' costs. We’ll have to wait several more months before the powers that be make their own determination. - Dina

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