United States Code
Title 42 – The Public Health and Welfare
Chapter 6A—Public Health Services
This part of the United States Code (U.S.C) is also known as the
Public Health Service Act. In 2012, the
Protection and Affordable Care Act amended the law in the course
of wide-ranging health care reforms.
The amended law (reproduced here in part) requires all group health care plans
(the kind of plan usually offered by businesses or oganizations) to offer coverage and
fully pay for "preventive services." Another part of
the law requires all businesses with 50 or more employees to offer
such coverage by 2014, or face penalties.1
Health insurance issuers (like insurance companies) must also make
available group and individual plans that fully pay for "preventive
"Preventive services" are not fully defined in the statute.
They are itemized in separate
recommendations, and in guidelines
that were not proposed until a year after the Patient Protection and
Affordable Care Act was passed.
The Obama administration has decided that, as a matter of public
policy, individual women should not have to pay for
contraceptive services," which include surgical sterilization,
contraceptives, and embryocides.2
for this policy are mainly economic and socio-political.
Contrary to an administration statement
on 10 February, 2012, the
regulation has not
been changed to accommodate objecting religious believers. The
wording and legal effect of the regulation remains exactly as it was
when it was
announced on 20 January, 2012.3
Since sterilization and birth control have to be paid for by
administration intends to force others to pay for them
through insurance plans, even if they object to doing so for reasons
of conscience or religion.
What follows is the part of the law that is the bais for the
regulation enacted to achieve this. Key terms are highlighted, links have been added for the convenience
of readers, and annotations are provided in text boxes to the right.
Subchapter XXV—Requirements Relating to Health
Part A—Individual and Group Market Reforms
Subpart ii—Improving coverage
§300gg–13. Coverage of preventive health
(a) In general
A group health plan and a health insurance issuer
offering group or individual health insurance coverage
shall, at a
minimum provide coverage for and shall not impose any cost sharing
(1) evidence-based items or services that have in
effect a rating of “A” or “B” in the
current recommendations of the United States Preventive Services
(2) immunizations that have in effect a
recommendation from the
Advisory Committee on Immunization Practices of
the Centers for Disease Control and Prevention with respect to the
individual involved; and1
(3) and (4) authorize the Health Resources
and Services Administration (an agency of the
Department of Health and Human Services) to develop "comprehensive
guidelines" to implement the law.
(3) with respect to infants, children, and
adolescents, evidence-informed preventive care and screenings provided
for in the comprehensive guidelines supported by the Health Resources
and Services Administration.2
The Health Resources and Services
Administration later enacted Required Health
Plan Coverage Guidelines.
(4) with respect to women, such additional
preventive care and screenings not described in paragraph (1) as
provided for in comprehensive guidelines supported by the Health
Resources and Services Administration for purposes of this paragraph.2
(5) for the purposes of this chapter, and for the
purposes of any other provision of law, the current recommendations of
the United States Preventive Service Task Force regarding breast cancer
screening, mammography, and prevention shall be considered the most
current other than those issued in or around November 2009.
Nothing in this subsection shall be construed to
prohibit a plan or issuer from providing coverage for services in
addition to those recommended by United States Preventive Services Task
Force or to deny coverage for services that are not recommended by such
Task Force. . . [Full
1. So in original. The word “and”
probably should not appear.
2. So in original. The period probably
should be a semicolon.
Provided by the Protection of Conscience Project
New Health Care Reform Law: How Will it Affect Non-Profit
Employers?" The Arc, National Policy Matters, Issue
#9, July 15, 2012.
2. The term "contraceptives," as it is used
in the guidelines (and, thus, the regulation) includes sterilization and
drugs and devices that may cause the death of a human embryo before
For an explanation of this terminology, see