Health Care Rules Mandate Birth Control With No Copay

It was announced today by the Obama administration that birth control must be covered under health insurance plans as preventive care for women, with no copays, the Associated Press is reporting.

The requirement is part of a broad expansion of coverage for women's preventive care under the president's health care law that could have far-reaching implications regarding insurance and social mores.

Also to be covered without copays are breast pumps for nursing mothers, an annual well-woman physical, screening for the virus that causes cervical cancer and for diabetes during pregnancy, counseling on domestic violence, and other services, the AP reports.

"These historic guidelines are based on science and existing (medical) literature and will help ensure women get the preventive health benefits they need," said Health and Human Services Secretary Kathleen Sebelius.

The new requirements take effect Jan. 1, 2013, in most cases.

Millions of women are expected to gain coverage initially, and that number is likely to grow with time, the AP reports. Some plans may be exempt due to a complex provision of the health care law known as the "grandfather" clause, but it’s expected these plans will face pressure from their members to include the new benefit.

Sebelius acted after a near-unanimous recommendation last month from a panel of experts convened by the Institute of Medicine, which advises the government, according to the AP. Panel chairwoman Linda Rosenstock, dean of public health at the University of California, Los Angeles, said that prevention of unintended pregnancies is essential for the psychological, emotional and physical health of women, the AP reported.

Today, almost all plans cover prescription contraceptives — but with varying copays. Medicaid, the health care program for low-income people, also covers contraceptives.

The market analysis firm INS health, reports that more than 90 million prescriptions for contraceptives were dispensed in 2009, according to the AP.

In a nod to social and religious conservatives, the rules issued Monday by Sebelius include a provision that would allow religious institutions to opt out of offering birth control coverage, the AP reports. Many conservatives are supporting legislation by Rep. Jeff Fortenberry, R-Neb., that would codify a range of exceptions to the new health care law on religious and conscience grounds, according to the AP.

The new health care mandate will be spread among other people with health insurance, resulting in slightly higher premiums, the AP reports. That may be offset to some degree with savings from diseases prevented, or pregnancies that are planned to minimize any potential ill effects to the mother and baby, according to the AP.

Health insurers will be able to charge copays for branded drugs in cases where a generic version is just as effective and safe for the patient, according to the AP.

The requirement applies to all forms of birth control approved by the Food and Drug Administration. That includes the pill, intrauterine devices, the so-called morning-after pill, and newer forms of long-acting implantable hormonal contraceptives that are becoming widely used in the rest of the industrialized world, the AP reports. But the rules issued Monday do not require coverage of RU-486 and other drugs to chemically induce an abortion.