On the Table: Reproductive Health

As part of the Affordable Care Act, the US Health and Human Services Department just announced new guidelines requiring insurance companies to offer free birth control:

Developed by the independent Institute of Medicine, the new guidelines require new health insurance plans to cover women’s preventive services such as well-woman visits, breastfeeding support, domestic violence screening, and contraception without charging a co-payment, co-insurance or a deductible.

According to the HHS Department website, the following will be included in all health insurance plans at no additional cost by August 1, 2012:

  • Well-woman visits: This would include an annual well-woman preventive care visit for adult women to obtain the recommended preventive services, and additional visits if women and their providers determine they are necessary. These visits will help women and their doctors determine what preventive services are appropriate, and set up a plan to help women get the care they need to be healthy.
  • Gestational diabetes screening: This screening is for women 24 to 28 weeks pregnant, and those at high risk of developing gestational diabetes. It will help improve the health of mothers and babies because women who have gestational diabetes have an increased risk of developing type 2 diabetes in the future. In addition, the children of women with gestational diabetes are at significantly increased risk of being overweight and insulin-resistant throughout childhood.
  • HPV DNA testing: Women who are 30 or older will have access to high-risk human papillomavirus (HPV) DNA testing every three years, regardless of pap smear results.  Early screening, detection, and treatment have been shown to help reduce the prevalence of cervical cancer.
  • STI counseling, and HIV screening and counseling: Sexually-active women will have access to annual counseling on HIV and sexually transmitted infections (STIs). These sessions have been shown to reduce risky behavior in patients, yet only 28% of women aged 18 to 44 years reported that they had discussed STIs with a doctor or nurse. In addition, women are at increased risk of contracting HIV/AIDS. From 1999 to 2003, the CDC reported a 15% increase in AIDS cases among women, and a 1% increase among men. 
  • Contraception and contraceptive counseling: Women will have access to all Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling. These recommendations do not include abortifacient drugs. Most workers in employer-sponsored plans are currently covered for contraceptives. Family planning services are an essential preventive service for women and critical to appropriately spacing and ensuring intended pregnancies, which results in improved maternal health and better birth outcomes.
  • Breastfeeding support, supplies, and counseling: Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment. Breastfeeding is one of the most effective preventive measures mothers can take to protect their children’s and their own health. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies.
  • Domestic violence screening: Screening and counseling for interpersonal and domestic violence should be provided for all women. An estimated 25% of women in the U.S. report being targets of intimate partner violence during their lifetimes. Screening is effective in the early detection and effectiveness of interventions to increase the safety of abused women. 

This historic victory for women’s rights (almost 4 decades after the invention of the birth control pill), came with its critics.  

Colbert comically sums up the retort to the new initiatives:

Vodpod videos no longer available.

CNN reports about the guidelines and their conservative critics:

The decision to offer contraception at no additional cost was not supported by everyone. For example, the Family Research Council claims the decision “undermines the conscience rights of many Americans.”

Cardinal Daniel DiNardo, chairman of Committee on Pro-Life Activities with the United States Conference of Catholic Bishops says “pregnancy is not a disease, and fertility is not a pathological condition to be suppressed by any means technically possible.” They feel the decision forces people to participate who may have moral or religious convictions that oppose contraception use.

The Obama administration released an amendment to the prevention regulation that allows religious institutions offering health insurance to their employees the choice of whether or not to cover contraception services.

Here’s a link to the guidelines, with pdfs at the bottom.  Happy Friday!

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