New healthcare law battle: Family planning

A major provision of Democrats' healthcare reform law has stoked a bitter fight over contraceptives.

Federal regulators must soon decide whether family planning should be included in the preventive care benefits that insurance plans must cover without a co-pay starting next year. Religious groups say an exemption carving them out is too narrow; women's groups don't think the exemption should exist at all.


The Department of Health and Human Services crafted the exemption in proposed regulations unveiled in August. Public comments were due by close of business Friday, and they flooded in.

"Should HHS persist in implementing the Interim Rule and its contraceptive mandate without major modifications, the Congregation will be forced to curtail its mission," read comments from Nashville's Dominican congregation.

"What war and disease could not do to the Congregation, the government of the United States will do. It will shut them down."

NARAL Pro-Choice America countered with a comment letter signed by 29,045 people.

"The proposed refusal provision would prioritize an institution's 'conscience' over the essential medical needs of women," the comments read. "We do not believe that it is appropriate for institutions at large to claim a 'conscience,' and to refuse to cover medical care that has been determined necessary by a woman's doctor. Refusal laws must not impede women's access to preventive-health-care services, and broad refusals applied to institutions do just that."

The proposed regulations mandate that new health plans cover contraceptive drugs and counseling without co-pays starting with plan years that begin Aug. 1, 2012. They do not apply to grandfathered plans that were in effect before the law was enacted on March 23, 2010, however. 

The health law required that plans cover preventive benefits starting Sept. 23, 2010, but regulators delayed rules for women's health until an Institute of Medicine made its recommendations, in part because of the controversy involved. The proposed rules build on those IOM recommendations and 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.

A final rule may be several months away.