In the coming months, the Department of Health & Human Services (HHS) is set to identify preventive health services that should be covered at no cost to patients, as required by the new health care law. For women, this would include mammograms and folic acid, as well as things like smoking cessation treatments.

But what about birth control?

Many advocates have been calling for birth control to be among the preventive services covered by insurance companies. There are many, many reasons why this makes sense. When you consider that birth control use is nearly universal among women in their reproductive years, it becomes even more clear how vital women consider family planning — for health and socioeconomic reasons. More specifically, as the NWLC points out,

Contraception is critical to helping women achieve healthy pregnancies.  Women who wait for some time after delivery before conceiving their next child lower their risk of adverse perinatal outcomes, including low birth weight, preterm birth, and small-for-size gestational age. And a planned pregnancy affords women an opportunity to make behavioral changes that lead to better birth outcomes…Many contraceptives have significant preventive benefits beyond their contraceptive benefits.  Oral contraceptives, for example, lower rates of pelvic inflammatory disease, cancers of the ovary and endometrium, recurrent ovarian cysts, benign breast cysts, and fibroadenomas.

Free birth control would also ease the burden of high health care costs for women, who on average earn less than men and pay more for health insurance:

On average, women earn only 78 cents for every dollar that men earn, and the median earnings of female workers working full time, year round, were $35,549 in 2009, compared to $45,485 for men. In addition, health insurance is often more expensive for women than it is for men and meets fewer of their needs.  Before the Affordable Care Act, insurance companies could refuse to sell a woman coverage due to her history of health problems or could charge a woman a higher premium on the basis of her sex…

Women are more likely than men to avoid needed health care, including preventive care, because of cost.  In 2007, for example, 52% of all nonelderly women reported a cost-related access barrier—not filling a prescription, skipping a recommended test or treatment, not getting needed basic or specialist care because of cost—compared to 39% of all nonelderly men. Preventive services are among those that women forgo because of cost; nearly half (45%) of women report delaying or not receiving a cancer screening or dental exam because of its cost, as compared to 36 percent of men. Evidence suggests that even moderate co-payments can cause individuals to forgo needed preventive care, particularly those with low and moderate incomes. (via NWLC)

Given the amount of change that will sweep through our health care system under the Affordable Care Act, the HHS asked the Institute of Medicine (IOM) to review what preventive services are important to women’s health and recommend which of these should be considered in the development of comprehensive guidelines. Earlier this week, the IOM recommended that women’s preventive services include improved cervical cancer & HIV screenings, at least one annual well-woman care visit, screening and counseling for all women and girls regarding interpersonal and domestic violence, AND (drum roll, please…..) “a fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes.”

Ta-da! This is a very welcome development. There is a plethora of evidence — both anecdotal and clinical — supporting the need to make birth control available at no cost to patients. One can only hope that the HHS takes the IOM’s recommendations under consideration. Women’s well-being depends on it.

What can you do? Be sure to take a moment and sign the NWLC’s petition to make contraceptives available without co-pays…. and tell your friends to do the same!

Categories: Health

Tags: Affordable Care Act, Birth control, Health care, Institute of Medicine, Insurance, National Women's Law Center, Preventive medicine, United States Department of Health and Human Services