Though health reform has already passed, the fight over what it really means is far from over. Especially when it comes to coverage of contraception, the devil is in the details. The law requires that preventive medications and measures be covered by insurers at no or low cost. But it doesn't specify what qualifies as prevention. So will birth control pills be on the list? 79 percent of women think they should be, according to a new survey of commissioned by the Planned Parenthood Federation of America. (Interestingly, fewer men-68 percent-see birth control pills as preventive health care.)
The chances seem good that the pill will make the cut when the U.S. Department of Health and Human Services issues its guidelines. (The law says this should happen by September, but don't be surprised if it's late.) Secretary of Health and Human Services Kathleen Sebelius seems to be supportive of contraception. And the American College of Obstetrics and Gynecology advocates that family planning should be a part of basic care.
Still, Planned Parenthood is not hedging their bets, having commissioned the survey as a sort of preventive measure of its own. The group smartly links support for insurance coverage of birth control to the 50 th anniversary of approval of the pill, which, it notes, has helped to slash numbers of unwanted pregnancies as well as maternal and infant mortality. Though there hasn't been much of a visible effort to push Sebelius to exclude contraception from preventive care, it's not unreasonable to fear one, given how bitter the health reform debate got over women's health issues-both before and after its passage.
Indeed, a flurry of activism to fill in the legislative gaps health reform left around abortion is well underway. Already, two states have passed bills that prohibit health care plans in state-based insurance exchanges from offering abortion services, and 29 have either introduced an opt-out bill, are planning to introduce a bill shortly, or are laying the ground work to introduce a bill as soon as their legislative calendars permit, according to Wonk Room .
With birth control, the fight is likely to be different. Instead of dividing states, we might see some division among methods, with the IUD excluded from coverage, say, while the pill is not.
Photograph of pill packets by Ceridwen, available under a Creative Commons Attribution-Share Alike 3.0 Unported license .