New health insurance plans will be required to cover birth control

The Obama administration on Monday announced that new healthcare plans will be required to cover contraceptive drugs and counseling without co-pays, starting next year.

The Health and Human Services guidelines, however, exempt some religious groups from having to offer the birth control coverage following an outcry from Christian conservatives.

The coverage guidelines largely reflect earlier recommendations from the Institute of Medicine that received overwhelming praise from women's health advocates last month. 

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"The Affordable Care Act helps stop health problems before they start," HHS Secretary Kathleen Sebelius said in a statement announcing the guidelines. "These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need."

The healthcare reform law requires new insurance plans to cover the prevention benefits without co-pays, co-insurance or deductibles for plan years that start on or after Aug. 1, 2012. The requirement does not apply to grandfathered plans that were in effect before the law was enacted on March 23, 2010, however.

The new benefits announced Monday include:

• Well-woman visits;

• Screening for gestational diabetes;

• Human papillomavirus (HPV) DNA testing for women 30 years and older;

• Counseling for sexually transmitted infections;

• Human immunodeficiency virus (HIV) screening and counseling;

• FDA-approved contraception methods and contraceptive counseling;

• Breastfeeding support, supplies and counseling; and

• Domestic violence screening and counseling.

The new guidelines exempt group health plans sponsored by certain religious employers. The guidelines define a religious employer as a nonprofit that has the inculcation of religious values as its purpose, primarily employs persons who share its religious tenets and primarily serves persons who share its religious tenets.

Sen. Barbara Mikulski, who championed coverage of women's preventive care in the heath law, applauded Monday's decision. The Maryland Democrat had written to Sebelius along with 28 colleagues urging the secretary to adopt the IOM recommendations.

"Today," she said in a statement, "I am so pleased that HHS has heeded the evidence-based advice of the IOM and decided to accept the recommendations, ensuring that American women will be less likely to forgo critical preventive screenings because they’re too expensive or not covered by health plans."

Other women's advocates, while pleased overall, however took issue with the exemption for religious employers.

"In allowing religious institutions to refuse to include contraceptive services in the health insurance plans they offer their employees, the Obama administration has once again sided with the Catholic bishops over the needs of women and their families," Jon O'Brien, president of Catholics for Choice, said in a statement. "The multi-billion dollar Catholic healthcare industry has a lot of influence with this administration, influence that it has now used to allow religious institutions to ride roughshod over the needs of their workers. Not only that, it ignores the consciences of those who decide that to use a modern method of family planning is what is best for them and their families."

"As we well know," Center for Reproductive Rights President and CEO Nancy Northup said in a statement, "religious adherents use birth control at the same rate as the general population. Individuals, not institutions, should make the personal decision about their use of health care and their own conscience."

And Debra Ness of the National Partnership for Women and Families said her group was "disappointed" by the exemption.

"That clause is unnecessary and potentially harmful, and was not recommended by the IOM committee," Ness said. "Every employer should be required to provide coverage for this basic preventive care, which is essential to women’s health. Allowing some employers to refuse to do so would create barriers that, for some women, may prove insurmountable. We intend to advise the Administration of our strong objection to the inclusion of such a clause."

This post was updated at 12:45 p.m. with reaction from Sen. Mikulski (D-Md.) and several advocates.