Following up on recommendations issued last month by the Institute of Medicine, the Department of Health and Human Services issued new guidelines today on mandatory care for women. Beginning August 2012, new health insurance plans will be required to include women’s preventive services such as well-woman visits, breastfeeding support, domestic violence screening, and, most controversially "contraception without charging a co-payment, co-insurance or a deductible."
H.H.S. Secretary Kathleen Sebelius said, “These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need.” The guidelines are part of a broader effort undertaken as part of health care reform to get more people into preventive services, which, according to the H.H.S., Americans use at half the recommended rate.
H.H.S. argues, "Family planning services are an essential preventive service for women and critical to appropriately spacing and ensuring intended pregnancies, which results in improved maternal health and better birth outcomes."
Sebelius' office also released an amendment to the new regs that "allows religious institutions that offer insurance to their employees the choice of whether or not to cover contraception services. This regulation is modeled on the most common accommodation for churches available in the majority of the 28 states that already require insurance companies to cover contraception." According to the statement: "H.H.S. welcomes comment on this policy."
They will likely get some comment soon. The U.S. bishops, which had been opposed to including contraception as a mandatory component of women's "preventive care," also sought explicit conscience exemptions from the policy. The U.S.C.C.B. is preparing a response to the new guidelines that should be issued sometime today.
UPDATE: The U.S. Conference of Catholic Bishops (USCCB) sharply criticized a new HHS “preventive services” mandate requiring private health plans to cover female surgical sterilization and all drugs and devices approved by the FDA as contraceptives, "including drugs which can attack a developing unborn child before and after implantation in the mother’s womb."
“Although this new rule gives the agency the discretion to authorize a ‘religious’ exemption, it is so narrow as to exclude most Catholic social service agencies and healthcare providers,” said Cardinal Daniel N. DiNardo, Archbishop of Galveston-Houston and chairman of the USCCB Committee on Pro-Life Activities. “For example, under the new rule our institutions would be free to act in accord with Catholic teaching on life and procreation only if they were to stop hiring and serving non-Catholics,” Cardinal DiNardo continued. “Could the federal government possibly intend to pressure Catholic institutions to cease providing health care, education and charitable services to the general public? Health care reform should expand access to basic health care for all, not undermine that goal.”
“The Administration’s failure to create a meaningful conscience exemption to the preventive services mandate underscores the need for Congress to approve the Respect for Rights of Conscience Act,” the Cardinal said. That bill (H.R. 1179), introduced by Reps. Jeff Fortenberry (R-NE) and Dan Boren (D-OK), would prevent mandates under the new health reform law from undermining rights of conscience.
Contraceptive services that will be covered under the new standards include "All Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity." That means the so-called abortion pill RU-486 and similar drugs are not covered, but that prohibition has not been enough to satisfy pro-lifers who are already attacking the new guidelines since the FDA recognizes the so-called morning-after pill, "Plan B" and Ella, as birth control.
Cardinal DiNardo added: “Catholics are not alone in conscientiously objecting to this mandate. The drugs that Americans would be forced to subsidize under the new rule include Ella, which was approved by the FDA as an ‘emergency contraceptive’ but can act like the abortion drug RU-486. It can abort an established pregnancy weeks after conception. The pro-life majority of Americans – Catholics and others – would be outraged to learn that their premiums must be used for this purpose.”
“HHS says the intent of its ‘preventive services’ mandate is to help ‘stop health problems before they start,’” said Cardinal DiNardo. “But pregnancy is not a disease, and children are not a ‘health problem’ – they are the next generation of Americans.
“It’s now more vital than ever that Congress pass the Respect for Rights of Conscience Act to close the gaps in conscience protection in the new health care reform act, so employers and employees alike will have the freedom to choose health plans in accordance with their deeply held moral and religious beliefs.
In addition to no-cost contraception, some of the less controversial new standards will allow women to have access to a full range of IOM recommended preventive services without cost sharing, including: well-woman visits; screening for gestational diabetes; human papillomavirus (HPV) DNA testing for women 30 years and older; sexually-transmitted infection counseling; human immunodeficiency virus (HIV) screening and counseling; breastfeeding support, supplies, and counseling; and domestic violence screening and counseling. H.H.S. projects that these changes will result in significant improvements in health outcomes for low-income women who may have been discouraged to seek out preventive services, even when they had health insurance, because of co-pays.