Finally, the day has come when all new insurance plans are required to cover preventive health care without any co-payments or deductibles. But despite reassurances from Congress and the White House that birth control would be covered under health reform, it didn’t make the list of essential preventive services. Instead, all anyone could promise was a future "study."
Comissioned by Kathleen Sebelius, the Secretary of Health and Human Services, the study is supposed to determine whether contraception is, in fact, a preventive health service. Allowing a year for the research, which is due next August, then additional time to issue new regulations, and, after that, a year in which insurers will have to comply with new regulations, it’ll be at least 2012 before women can get birth control without a hefty co-pay. 2013 is more likely.
Women’s health advocates have sent a letter urging Sebelius to shorten, or better yet, eliminate the delay. "There’s no need to study for an entire year whether birth control is a preventive services," says Lois Uttley, co-founder of Raising Women’s Voices, one of the more than 60 organizations that signed the letter. "They can come to a conclusion on that issue in a matter of weeks by simply reviewing the existing scientific and medical evidence." Alternatively, she suggests, they could simply add birth control to the list with no further ado.
But quick resolution doesn’t look likely. In a move that’s brought unpleasant flashbacks to last Winter and Spring, the Catholic Church is waging its own campaign. According to a letter the U.S. Conference of Catholic Bishops sent to HHS last week, contraceptives and sterilization should not be considered preventive services. "To prevent pregnancy is not to prevent a disease," the bishops’ letter explains, going on to argue that the interim list, which doesn’t include birth control, should be made permanent.
And then, of course, there’s the debate about abortion, which will be as bitter as it was last time around. Though the final law included abortion language that was less restrictive than the total ban that had been proposed by anti-choice Democrat Bart Stupak, the same Stupak-like language that enraged abortion rights supporters less than a year ago has returned. And this time, the White House and HHS apparently inserted it themselves. After complaints from the National Right to Life Committee this summer, the administration announced that its temporary health plans for high-risk adults could only offer abortion coverage in cases of rape, incest, or life endangerment.
Meanwhile, congressional members who wanted an out-and-out ban on abortion during the first health reform go-round have re-introduced legislation that would, like the old Stupak amendment, ban private insurers from covering abortions.
While their chances of passing the "No Taxpayer Funding for Abortion Act" may be slim, they have a healthy shot at rehashing bitter debates. And, as we’re already seeing with birth control, that can delay access to services, or even prevent them forever.
Photograph of birth control pills by Ceridwen for Wikimedia Commons.