Will mandatory contraception coverage increase costs?

To the dismay of many health payers, the Department of Health & Human Services (HHS) moved quickly to act upon recent recommendations requiring insurers provide free contraceptives and other preventive health services for women. The HHS guidelines, which are identical to an Institute of Medicine report issued a few weeks ago, take effect Aug. 1, 2012. Insurance plans operating based on a calendar year have until January 2013, the New York Times reports.

"Since birth control is the most common drug prescribed to women ages 18-44, insurance plans should cover it," HHS Secretary Kathleen Sebelius said when announcing the new guidelines. "Not doing it would be like not covering flu shots, or any of the other basic preventive services that millions of other Americans count on every day." 

Insurers, however, are fearful that covering birth control and other federally-approved contraception could lead to higher costs. Karen Ignagni, president of America's Health Insurance Plans, said the guidelines would increase the number of unnecessary physician office visits and raise the cost of coverage. She also warned the recommendations would broaden the scope of mandated preventive services beyond existing evidence-based guidelines, suspend current cost-sharing arrangements for certain services, and encourage consumers to obtain a prescription for routine supplies that are currently purchased over-the-counter, according to CNN.

HHS clarified that insurers can use "reasonable medical management techniques" to control costs and promote efficient care delivery by, for example, charging co-payments for brand-name drugs if a lower-cost generic version was available and was just as safe and effective, the Times notes.

In an attempt to address contraception opponents, HHS is allowing religious organizations to opt out of the requirement if contraception coverage contradicts their beliefs. However, it specifically asked for public comment on that portion of the rules, "as we work to strike the balance between providing access to proven prevention and respecting religious beliefs," NPR Shots reports.

To learn more:
- read the HHS guidelines
- read the NPR Shots blog post
- see the New York Times article
- check out the CNN story

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