Monday, July 01, 2013

Contraception and the ACA

Last week the Department of Health and Human Services announced its final guidelines on the birth control benefit of the Affordable Care Act, making clear that everyone must have access to birth control at no cost, no matter where they work.  Planned Parenthood released a white paper, "Taking Control," 39 pages long, on the way birth control has affected women and American society, and how the ACA expand that benefit, as well as some possible clouds on the horizon.

This is the first paragraph of the executive summary:

Birth control has had such a dramatic impact on women and families in this country that the Centers for Disease Control and Prevention (CDC) named it one of the top 10 public health achievements of the past century. Now, with implementation of the Affordable Care Act (ACA), America is poised to experience the single biggest advancement in women’s health in a generation, one that is already making a huge difference in the lives of women across the country. The new law provides insurance coverage to more women including birth control and well-woman visits with no co-pay for the first time, increases access to reproductive health
care, and eases the disproportionate health care burdens on women, who still earn less than men and often face higher health care costs.

Some of the key points mentioned regarding the impact of readily available contraception:

  • fewer unintended pregnancies and therefore fewer abortions
  • allows couples to reach educational and career goals before starting a family
  • women who have planned pregnancies are more likely to seek out prenatal care, leading to healthier babies and mothers

The report notes that there has been political resistance to the ACA, although there is widespread support among voters, with 70% supporting access to contraception with no insurance co-pay:

To date, the House of Representatives has voted at least 37 times to repeal the health care law, taking up an estimated 15 percent of the people’s business  on the issue in the midst of an economic crisis, domestic terrorism attacks, weather disasters, and other pressing matters. Nearly 60 lawsuits have been filed by businesses and not for-profit groups challenging the requirement to provide birth control without cost-sharing for millions of women, and it is expected that at least one of these challenges will reach the Supreme Court. In addition, numerous states have introduced bills to repeal or undermine women’s health coverage in the ACA. 

Among those suing are 32 for profit privately owned companies.  Yes, your employer wants to be able to decide what kind of health care you can receive.  Note this:

What all of these employers have in common is the conviction that their personal beliefs should dictate their employees’ access to health care — including whether women get access to affordable birth control. In legal papers, the bosses call the birth control benefit “sinful and immoral,” and often wrongly equate contraception with abortion. 
Would that mean an employer could decide that families should not have access to in vitro fertilization or ED medications?  Will there be required snake handling at the next corporate retreat?  No caffeine products (coffee, chocolate) purchased with pooled employee funds?  How far would this droit de seigneur go?  (The report lists some of the companies that have sued.).

It was only 50 years ago that the Supreme Court, in Griswold v. Connecticut ruled that married couples could legally use birth control.  In that 50 years the incidence of maternal and infant mortality have dropped dramatically.

It's an interesting report and won't take that long to read.  Give it a look see.

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