Women's Preventive Services
Required Health Plan Coverage
Guidelines [Full text]
U.S. Department of Health and Human
Services
Introduction:
The Obama administration has decided that, as a matter of public
policy, individual women should not have to pay for
"FDA approved
contraceptive services," which include surgical sterilization,
contraceptives and
embryocides.
The
reasons offered
for this policy are mainly economic and socio-political.
Since sterilization and birth control have to be paid for by
someone, the 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.
The
preventive services regulation written
by the U.S. Department of Health and
Note:
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.
Human Services requires all
health insurance plans to pay fully for every service described in
Section 147.130 of the regulation. Among these are all
services for women that are identified in "
binding comprehensive health plan coverage guidelines supported by the
Health Resources and Services Administration."
These guidelines are reproduced below.
The combined effect of the statute, the
regulation and the
guideline is that eight types of service
must be provided and paid for fully by insurance plans. This will
affect all employers who have 50 or more employees, since the law also
requires them to offer such coverage by 2014, or face penalties.1
Within the context of freedom of conscience concerns, seven kinds
of service are unremarkable. However, the demand that
employers must provide insurance coverage that fully
pays for "contraceptive methods and counseling" is highly
controversial for several reasons:
-
pregnancy is treated as a pathological condition
like gestational diabetes, HPV infection and sexually
transmitted diseases;
- some religious denominations have moral objections to
contraception, either absolutely or in certain cicumstances;
-
"contraceptive methods" as defined by the FDA are not limited to contraception,
but include contraceptive sterilization, which may be considered
gravely wrong by some religious denominations, either absolutely
or in certain circumstances;
-
"contraceptive methods" as defined by the FDA include methods that may not prevent conception,
but may cause the death of a human embryo.
A number of religious denominations have
strong moral objections to causing the death of an embryo,
considering it the moral equivalent of
abortion.
-Administrator
Health Resources and Services Administration Supported Women's
Preventive Services: Required Health Plan Coverage Guidelines
Non-grandfathered plans and issuers are required to provide
coverage without cost sharing consistent with these guidelines in the
first plan year (in the individual market, policy year) that begins on
or after August 1, 2012.
|
Type of
Service
|
HHS Guideline for
Health Insurance Coverage
|
Frequency
|
|
Well-woman visits.
|
Well-woman preventive care visit annually for adult women to
obtain the recommended preventive services that are age and
developmentally appropriate, including preconception and
prenatal care. This well-woman visit should, where appropriate,
include other preventive services listed in this set of
guidelines, as well as others referenced in section 2713.
|
Annual, although HHS recognizes that several visits may be
needed to obtain all necessary recommended preventive services,
depending on a woman's health status, health needs, and other
risk factors.* (see note)
|
|
Screening for gestational diabetes.
|
Screening for gestational diabetes.
|
In pregnant women between 24 and 28 weeks of gestation and at
the first prenatal visit for pregnant women identified to be at
high risk for diabetes.
|
|
Human papillomavirus testing.
|
High-risk human papillomavirus DNA testing in women with
normal cytology results.
|
Screening should begin at 30 years of age and should occur no
more frequently than every 3 years.
|
|
Counseling for sexually transmitted infections.
|
Counseling on sexually transmitted infections for all
sexually active women.
|
Annual.
|
|
Counseling and screening for human immune-deficiency virus.
|
Counseling and screening for human immune-deficiency virus
infection for all sexually active women.
|
Annual.
|
|
Contraceptive methods and counseling.
** (see note)
|
All Food and Drug
Administration approved
|
As prescribed.
|
|
Breastfeeding support, supplies, and counseling.
|
Comprehensive lactation support and counseling, by a trained
provider during pregnancy and/or in the postpartum period, and
costs for renting breastfeeding equipment.
|
In conjunction with each birth.
|
|
Screening and counseling for interpersonal and domestic
violence.
|
Screening and counseling for interpersonal and domestic
violence.
|
Annual.
|
health
plans sponsored by certain religious employers, and group health
insurance coverage in connection with such plans, are exempt from the
requirement to cover contraceptive services. A religious employer is one
that: (1) has the inculcation of religious values as its purpose; (2)
primarily employs persons who share its religious tenets; (3) primarily
serves persons who share its religious tenets; and (4) is a non-profit
organization under Internal Revenue Code section 6033(a)(1) and section
6033(a)(3)(A)(i) or (iii). 45 C.F.R. §147.130(a)(1)(iv)(B). See the
Federal Register Notice:
Group Health Plans and Health
Insurance Issuers Relating to Coverage of Preventive Services Under the
Patient Protection and Affordable Care Act
Notes
Provided by the Protection of Conscience Project
1. "The
New Health Care Reform Law: How Will it Affect Non-Profit
Employers?" The Arc, National Policy Matters, Issue
#9, July 15, 2012.