Insurers Must Cover Birth Control With No Copays

birth control pill 1317364 Insurers Must Cover Birth Control With No Copays

A woman holds prescription birth control pills. (credit: Tim Matsui/Getty Images)

WASHINGTON (AP) – Health insurance plans must cover birth control as preventive care for women, with no copays, the Obama administration said Monday in a decision with far-reaching implications for health care as well as social mores.

The requirement is part of a broad expansion of coverage for women’s preventive care under President Barack Obama’s health care law. 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.

“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 will take effect Jan. 1, 2013, in most cases. Over time, they are expected to apply to most employer-based insurance plans, as well as coverage purchased individually.

Sebelius acted after a near-unanimous recommendation last month from a panel of experts convened by the prestigious Institute of Medicine, which advises the government. 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.

As recently as the 1990s, many health insurance plans didn’t even cover birth control. Protests, court cases, and new state laws led to dramatic changes. Today, almost all plans cover prescription contraceptives — with varying copays. Medicaid, the health care program for low-income people, also covers contraceptives.

Indeed, a government study last summer found that birth control use is virtually universal in the United States, according to a government study issued last summer. More than 90 million prescriptions for contraceptives were dispensed in 2009, according the market analysis firm INS health. Generic versions of the pill are available for as little as $9 a month. Still, about half of all pregnancies are unplanned. Many are among women using some form of contraception, and forgetting to take the pill is a major reason.

Preventing unwanted pregnancies is only one goal of the new requirement. Contraception can help make a woman’s next pregnancy healthier by spacing births far enough apart, generally 18 months to two years. Research links closely spaced births to a risk of such problems as prematurity, low birth weight, even autism. Research has shown that even modest copays for medical care can discourage use.

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. However, 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.

Although the new women’s preventive services will be free of any additional charge to patients, somebody will have to pay. The cost will be spread among other people with health insurance, resulting in slightly higher premiums. 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.

The administration did allow insurers some leeway in determining what they will cover. For example, health plans will be able to charge copays for branded drugs in cases where a generic version is just as effective and safe for the patient.

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.

Coverage with no copays for the morning-after pill is likely to become the most controversial part of the change. The FDA classifies Plan B and Ella as birth control, but some religious conservatives see the morning-after drugs as abortion drugs. The rules HHS issued Monday do not require coverage of RU-486 and other drugs to chemically induce an abortion.

Advocates say the majority of women will be covered once the requirement takes effect in 2013, although some insurance plans may opt to offer the benefit earlier. Aside from the religious conscience clause, there is one additional exception. Plans that are considered “grandfathered” under the law will not be affected, at least initially. Consumers should check with their health insurance plan administrator.

(© Copyright 2011 The Associated Press. All Rights Reserved. This material may not be published, broadcast, rewritten or redistributed.)

  • Mary Mary

    great news. women’s health issue always seem to lag behind.

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  • rubbercow

    This is the smartest thing our government has ever done. We do not need more unwanted people.

  • RussP

    I agree with birth control being covered but I’m not so sure about the no copay rule and things like breast pumps and wellness screenings. Once this takes affect, will other groups start demanding the same status for other drugs and treatments? Will we start having guys wanting their Viagra with no copay or how about free screenings for all genetic diseases? This says the cost will be passed on to all those carrying insurance so this can really hit us in the pocket book if it becomes over used.

    • leslee

      and it will be overused. i see people on public assistance go in to the doctor several times a week for a sniffle. running up their medical bill on our dime but it makes no difference to them because they arent paying for it.

  • Cheryl

    I’m personally against the pill however if someone else is wanting it, that’s their business but they should pay a copay. This will be paid for by those with insurance that will see yet another raise in premiums to cover another “freebie”. I’m getting tired of paying for all these ‘freebies”.

  • NiteNurse

    Finally women are getting equal footing with men. There was a time when insurance would pay for vigara and not birth control which I found really stupid. It’s like hey we’ll pay to help you make babies and deliver babies but not to prevent you from having them.

  • Leslee

    i do not agree with the birthcontrol issue. birthcontrol is not that expensive. i pay 75 dollars every three months for depo. thats 25 dollars a is a good idea for insurance to cover it but with no copay, come on really? im a single mom with 2 kids and if i can afford it so can anyone else. its much cheaper than another child. everyone wants a free ride and that is a big problem in this country if you ask me.all anyone has to do these days is say they have back pain or a mental condition and they are paid for the rest of their life and the rest of us that work have to compensate for their laziness. i was on public assistance at one time but i worked hard to get off of it and i cant believe our government doesnt force those on public assistance to do the same. it just irritates me! I agree with cheryl im tired of paying for everyone elses freebies! why dont we just have the government offer low cost permanent birth control then there would be no risk of having an unwanted pregnancy because someone forgot to take their free pills.

    • NiteNurse

      Having a baby and caring for it with insurance is far more expensive for an insurance company then birth control. Dollars and sense people! Besides if insurance will pay for erectile dysfunction drugs without a co-pay why not birth control? It’s not a freebie if you work and pay for insurance they are just getting rid of the co-pay.

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  • Rick McDaniel

    Better to do that, than bring unwanted babies into this world. We already have far too many humans, anyway.

    Of course, there is no question, ObamaCare is going to cost us all, dearly. Blame the people responsible……the Dems…….aka, the welfare party.

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