Prevailing standards of medical care recognize family planning services as a necessary component of preventive care for women. And health insurance coverage decisions should be based on standards of medical care recognized by professional medical academies. So, when regulations from the U.S. Department of Health and Human Services (HHS) required most health insurance plans to cover all forms of FDA-approved methods of birth control without cost-sharing, it seemed like a logical decision, but not to everyone.
There are currently over 40 cases challenging the evidenced-based federal contraceptive coverage rule. The arguments in these cases focus on whether the requirement that most employee health insurance coverage include birth control violates the employer’s religious freedom. Now remember, the federal rule doesn’t apply to certain houses of worship. The federal government has also proposed an accommodation for certain other religiously-affiliated employers, which would allow them to refuse to pay for contraceptive coverage and instead have insurance companies provide the coverage. Still, the plaintiffs in these cases argue that they should be able to decide on appropriate health care services for their employees—regardless of what evidenced-based medicine says. They also contend, sometimes implicitly, that the contraceptive coverage requirement is a radical departure from the way that health insurance has previously been regulated in this country. These arguments, however, disregard the recommendations of the professional medical academies and the independent Institute of Medicine, as well as federal laws and policies pre-dating the Patient Protection and Affordable Care Act (ACA). They also would allow an employer’s personal beliefs to trump a woman’s own decision about birth control. That is precisely what the National Health Law Program (NHeLP) argues in its amicus brief filed in Frank O’Brien v. Department of Health and Human Services.
The ACA requires new group health plans and health insurance issuers to cover a wide range of preventive health services, including U.S. Preventive Services Task Force recommendations and women’s health preventive care and screenings as provided for in guidelines supported by HHS. The HHS guidelines were established by a rigorous scientific review by the Institute of Medicine. NHeLP’s amicus brief explains that the federal contraceptive coverage rule is evidenced-based, grounded in accepted standards of medical care recognized by various professional medical academies. These standards of care recommend family planning services as preventive care for a variety of reasons, including appropriate birth spacing, protection of women with certain medical conditions, and avoidance of the use of drugs that are harmful during pregnancy. The ACA rule simply puts into place long-standing expert recommendations and continues a long history of government support for evidence-based family planning counseling, services, and supplies.
The ACA’s contraceptive coverage requirement is good medical and economic policy. It’s good for the health and well-being of women and their families, and it’s good for public health. It really is a no-brainer.
This guest blog post was prepared by Dipti Singh, J.D., Staff Attorney at the National Health Law Program.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state. The views expressed in this blog do not represent those of the Robert Wood Johnson Foundation