No copay urged on birth control

WASHINGTON – An independent panel of doctors and health experts recommended Tuesday that health plans cover a broad range of contraceptives for women without copayments, setting the stage for another debate over the impact of the health care overhaul.

The law that President Barack Obama signed last year requires new health plans to cover many preventive health services without copayments or deductibles for patients, a key provision that experts believe will encourage more Americans to get recommended immunizations, cancer screenings and other services.

But the law directed the Department of Health and Human Services to seek input from clinicians and other authorities about which additional services should be covered for women.

That prompted the report Tuesday from the Institute of Medicine, a branch of the National Academy of Sciences that provides guidance to policymakers.

Among eight recommendations, the panel urged coverage for “the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling.”

With close to half of all pregnancies unplanned in the U.S., many experts see easy access to contraception as critical to women’s and babies’ health. Mothers with unwanted pregnancies are less likely to receive prenatal care and to engage in unsafe behaviors such as drinking and smoking, according to research cited by the IOM.

Secretary of Health and Human Services Kathleen Sebelius called the recommendations “historic” and said her department would review them before it finalizes regulations “very soon” specifying which preventive services will have to be covered.

Dr. Linda Rosenstock, who chaired the IOM panel, said the Obama administration would likely have to consider other issues beyond the scientific recommendations provided by the panel.

“Our decision was based on the evidence of what works and not what the cost of them is,” she said. “These are issues that will need to be considered.”

The recommendations, endorsed by all but one of the 16 IOM panel members, drew praise Tuesday from numerous women’s health advocates, as well as leading Democrats on Capitol Hill.

“Making family-planning services available at no cost will help millions of women prevent unintended pregnancy and thereby reduce the need for abortion,” said NARAL Pro-Choice America President Nancy Keenan.

The IOM report noted that contraceptive coverage is now “standard practice” for most private insurance plans and federally funded insurance programs.

And since 2007, the National Business Group on Health, an organization of large employers that provide coverage to about 50 million workers, retirees and dependents, has recommended coverage of family planning services without cost sharing.

But some anti-abortion groups have objected to expanding coverage for contraception, singling out several emergency contraceptives such as Plan B or Ella that can prevent implantation of a fertilized egg.

“A federal mandate to all insurance plans to include drugs such as Ella essentially would mandate coverage for abortion,” said Jeanne Monahan, director of the Family Research Council’s Center for Human Dignity.

Monahan said a requirement to cover these drugs would also violate the rights of insurers, medical providers and others who object to abortion.

The recommended coverage would not include the controversial drug mifepristone, or RU-486, which can end an established pregnancy, said Alina Salganicoff, an IOM panel member and director of women’s policy at the nonprofit Kaiser Family Foundation.

Mammograms for women over 40 are already be covered by new health plans without cost-sharing.