CQ TODAY ONLINE NEWS
Feb. 10, 2012 – 9:33 p.m.
Demand for Contraception Suddenly Becomes a Front-Burner Issue
By Jane Norman, CQ HealthBeat Associate Editor
A largely sidelined aspect of women’s health care policy — birth control services — is drawing new attention because of the uproar over an Obama administration rule now revised to require the health insurance companies of hospitals, universities and charities with religious affiliations to provide free contraceptive coverage.
Abortion has long dominated as the most controversial issue in the portfolio of women’s health policy, sparking decades-long partisan and religious battles that have been waged in and out of Congress and the federal courts, to say nothing of public opinion.
In this case, the contested issue is whether women working for employers with religious affiliations should have access to a package of no-cost, preventive health benefits that include birth control services. Opponents with deep-seated religious objections say no, and proponents counter that such coverage is in high demand.
Indeed, research shows use of contraceptives — which were once outlawed — is now deeply ingrained in American life. It’s about as prevalent as driving a car or using a credit card. About 99 percent of sexually active women have used at least one method of birth control during their lifetime, says the Guttmacher Institute. That includes 98 percent of Roman Catholics, whose leaders are at the vanguard of the opposition to the administration’s requirement set out in the health care law (PL 111-148, PL 111-152).
Advocates of reproductive rights say the ability to plan for children is fundamental to women’s lives and health. “Contraception is a very, very important part of women’s health care,” says Sarah Brown, chief executive officer of the National Campaign to Prevent Teen and Unplanned Pregnancy. “It’s transformed the lives of women not only in this country but around the world.”
The Centers for Disease Control and Prevention cites the development of effective family planning as one of the 10 greatest public health achievements of the 20th century, on par with immunizations. And it reduces health care costs by preventing multiple pregnancies, high-risk pregnancies and abortions — a factor that Brown said “seems to be lost in this debate.”
About 62 percent of the 62 million American women between the ages of 15 and 44 currently use some form of contraception. The most popular method is the pill, used by 28 percent of women, followed by tubal sterilization and male condoms.
Adam Sonfield, a senior public policy associate with Guttmacher, said federal and state government agencies spend $1.85 billion a year on family planning services, which also include related services such as testing for sexually transmitted diseases. In a change from two decades ago, most of the employer-sponsored health insurance plans used by 59 percent of Americans now cover such contraception services.
The fundamental change, endorsed by the administration’s regulation, is that preventive care will be free under the health care law, said Sonfield, who expects to see an uptick in contraceptive use as a result.
Under strong opposition, President Obama announced Feb. 10 that he would alter the earlier rule, released Jan. 20, requiring such institutions to offer health insurance that includes contraception services to their employees. The change will relieve institutions with religious objections from the mandate that their health insurance provide free birth control coverage. Instead, the rule will shift that burden to insurance providers.
The rule will provide employees free coverage for birth control methods approved by the Food and Drug Administration, including sterilization, diaphragms, condoms, birth control pills, cervical caps, spermicide and IUDs and the “morning-after” and “week-after” pills, which some Catholics regard as equivalent to abortion. Only faith groups such as churches, mosques and synagogues will be exempt from the requirement.
The revised rule still includes a one-year transition period to give religious-affiliated institutions until Aug. 1, 2013, to comply.
Supporters say the requirement strikes a balance for female workers of all faiths. Mary Kay Henry, Service Employees International Union president, said making exemptions to the rule threatened coverage that nearly 500,000 nurses in Catholic hospitals and universities support.
Demand for Contraception Suddenly Becomes a Front-Burner Issue
Opponents Unbowed
Still, Obama’s move did not completely quiet the furor of opponents who say the rule diminishes their religious liberty. Litigation is already under way as two colleges and a Catholic media network have filed federal lawsuits. Opponents in Congress, led by House Speaker
Still, religious institutions are hardly monolithic and are reacting differently. Indeed, some institutions in the 28 states that already require contraceptive coverage cover such services. The Catholic Health Association includes more than 2,000 health systems, hospitals and long-term-care facilities with an estimated 640,000 employees. And there are 200-plus members of the Association of Catholic Colleges; Catholic higher education institutions employ about 107,000 people.