New Battle Brewing Over Family Planning Coverage in ObamaCare

By Susan Brinkmann, OCDS
Staff Journalist

The Department of Health and Human Services (HHS) is finalizing rules for coverage of preventive services under the new healthcare reform law, and may include “family planning” services, which would not only result in paying for drugs that cause abortions but also threaten conscience protections.

The Patient Protection and Affordable Care Act requires that, starting Thursday, new health plans cover preventative care benefits without deductible, co-pay or coinsurance. Even though regulators deferred a decision to include “preventive care and screening” services specifically for women until August 2011, Planned Parenthood and other entities are already pressing for coverage of “all forms of FDA-approved prescription contraception.”

According to The Hill, many regulators are in favor of the idea. For instance, Montana’s commissioner of securities and insurance believes family planning should be included because of the high cost of pregnancy.

“Pregnancy is an expensive proposition and prevention of unplanned pregnancy is highly cost effective,” writes Commissioner Monica Lindeen. “For every public dollar invested in contraception, nearly $3.75 is saved in Medicaid expenditures that would have been needed for prenatal care, labor and delivery, postpartum care, and the infant’s first year of medical care.

“In addition, the costs of complications can be very high. Women with unplanned pregnancies have more complicated pregnancies and deliveries on average due to increased likelihood of inadequate prenatal care, exposure of the fetus to harmful substances, and low birth weight.”

But many disagree, such as the U.S. Bishops, who cite numerous reasons why including contraception and sterilization on a list of “preventive” services shouldn’t be allowed.

“These drugs, devices and procedures prevent not a disease condition, but the healthy condition known as fertility,” said Anthony Picarello, USCCB general counsel, and Michael Moses, associate general counsel, in a September 17 letter to HHS. They added that contraception and sterilization “pose significant risks of their own to women’s life and health; and a federal program to mandate their inclusion would pose an unprecedented threat to rights of conscience.”

Picarello and Moses argued that contraception cannot be considered “preventive” on the grounds of preventing abortion because “abortion is not itself a disease condition, but a separate procedure that is performed only by agreement between a woman and a health professional,” and “studies have shown that the percentage of unintended pregnancies that are ended by abortion is higher if the pregnancy occurred during use of a contraceptive.”

They noted that at least one drug already approved by the Food and Drug Administration (FDA) for “emergency contraception” can actually cause early abortions, so a mandate of prescription contraception coverage as a preventive service would “be in direct tension with [PPACA’s] statutory prohibition on mandating any abortion service.”
They also noted that such a mandate would threaten “rights of conscience for religious employers and others who have moral or religious objections to these procedures. In this regard, the Administration’s promise that Americans who like their current coverage will be able to keep it under health care reform would be a hollow pledge.”

They added that this “would also contradict longstanding federal precedents on respect for conscientious objection to such procedures and such coverage,” including the Church amendment, which since 1973 has protected conscientious objection to abortion and sterilization.

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