National NOW Times >> Fall 2011  >> Article

Birth Control Coverage Victory May Come with a Catch

In early August, NOW commended the Department of Health and Human Services (HHS) for issuing new guidelines for insurance plans to cover women's preventive health services under the Affordable Care Act. Included among these guidelines, as recommended by the Institute of Medicine, are well-woman visits, support for breastfeeding equipment, domestic violence screening and the provision of contraceptive services without co-pays or deductibles.

In a letter to HHS Secretary Kathleen Sebelius, NOW had called for the full adoption of these recommendations, stating that significant progress could be made toward "reducing health disparities affecting racial and ethnic minorities, expanding access for young women and those with moderate incomes as well as generally improving the health status of women and their infants." NOW also urged the department to exclude refusal or conscience clauses that would undermine women's access to birth control.

Unfortunately, the regulations do allow religious institutions the option of not covering contraception services when offering insurance to their employees. HHS noted that "this is the most common accommodation for churches available in a majority of the 28 states that already require insurance companies to cover contraception."

NOW President Terry O'Neill objected that no woman should be denied health care as basic as contraception, not even a woman who happens to work for a religious institution.

"The U.S. Constitution guarantees freedom of religion and freedom from being forced to observe any particular religious dictate," said O'Neill. "This so-called conscience clause is bad enough -- but even worse, we've heard that a more expansive refusal clause may be included in the final regulation. That's unacceptable. It would be a tragedy if millions of women were denied affordable access to contraception because HHS is ready to give in to a tiny minority of religious extremists who oppose birth control."

A comment period is currently in effect until Sept. 17. NOW will submit comments reminding HHS that an increasing number of health care refusals are undermining medical standards of care and patient health and safety.

"The progress set into motion by these new regulations must not be compromised by ideologically driven loopholes," said O'Neill.

O'Neill also expressed disappointment that HHS will not require insurers to implement this change immediately, allowing them to wait a full year before providing women's preventive services without co-pays or deductibles.

"There is no good reason for further delay," O'Neill said. "Women need preventive health services now, especially as they are economically squeezed by unemployment or underemployment."