By Susan Brinkmann, OCDS
A Catholic physician says that if the Patient Protection and Affordable Care Act (PPACA) is permitted to mandate birth control and other forms of artificial contraception, it should also be allowed to demand coverage for natural family planning (NFP) methods.
First and foremost, family practitioner Denise J. Hunnell, MD is asking Congress to bring the (PPACA) into line with the unbroken legal tradition of respect for the rights of conscience. In an article she wrote for HLI America, she states:
“Those who sponsor, purchase and issue health plans should not be forced to violate their deeply held moral and religious convictions in order to take part in the health care system or provide for the needs of their families or their employees. To force such an unacceptable choice would be as much a threat to universal access to health care as it is to freedom of conscience.”
Second, she believes the PPACA should also be made to cover training for NFP.
“Natural Family Planning (NFP) using a symptothermal (SMT) method such as that taught by the Couple to Couple League or the Creighton Method is as effective as oral contraceptives when postponing pregnancy,” she writes.
Dr. Hunnell references a well-designed 2007 study by Professor Petra Frank-Hermann and published in the European journal Human Reproduction which tracked 900 women using this type of NFP method for over 20 years.
“For a contraceptive method to be rated as highly efficient as the hormonal pill, there should be less than one pregnancy per 100 women per year when the method is used correctly,” Dr. Frank-Hermann wrote. “The pregnancy rate for women who used the STM method correctly in our study was 0.4%, which can be interpreted as one pregnancy occurring per 250 women per year. Therefore, we maintain that the effectiveness of STM is comparable to the effectiveness of modern contraceptive methods such as oral contraceptives, and is an effective and acceptable method of family planning.”
NFP using the STM method also compared well to drop-out rates from other methods of family planning, meaning the method is just as acceptable to couples as other forms.
“Recognizing NFP as a legitimate form of family planning that would be covered by insurance would be of great benefit to Catholic couples and to the many green-conscious couples turning to NFP,” Dr. Hunnell writes.
A Couple to Couple League training class in SMT can cost around $135.00. The home study version costs $161.00. Physicians who provide patient education on NFP could be reimbursed for this service and have more of an incentive to recommend NFP if it was included as an option for family planning, Dr. Hunnell says.
“If education and counseling for chemical and surgical methods of family planning are covered by insurance, it seems only fair that education for Natural Family Planning be covered as well.”
Just for the record, she makes it clear that she is uncomfortable with lumping NFP in the same category as contraceptives, abortifacients and sterilization because, when properly used, NFP does not distort or compromise marital intimacy by separating the unitive and procreative aspects of the marital act, which is what distinguishes it from chemical and barrier methods of contraception. However, she believes that education about a reliable, economical and side-effect free family planning method like NFP should be included in the array of mandated coverage.
“The Institute of Medicine and Department of Health and Human Services made a glaring mistake in declaring contraceptives to be a mandated preventive service, primarily because pregnancy is not a disease that needs to be prevented. Fertility is not a disorder that needs to be cured. My proposal does not right that mistake: it simply prevents the mistake from being compounded by the exclusion of a legitimate and scientifically-based form of family planning.”
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