Institute Of Medicine Recommends Contraceptives Be Considered Preventive Services Under Health Care Law

July 20, 2011 9:26 am ET — Meredith Kormes

With all the talk of "rationing boards" and "Medicare cuts," Republicans have created a lot of noise about the supposed evils of the Affordable Care Act. Many of the distortions may have been generated, in part, to distract the public from the actual, tangible impact the health care law has already had on many Americans. The law's provision to provide preventive services to Americans on Medicare is one example; approximately 5.5 million seniors have already seen the real benefits of the law with mammograms and prostate cancer screenings.

Another tangible benefit emerged Tuesday with the historic step from the Institute of Medicine (IOM) in which they address the unique health needs of women by identifying gaps in their preventive care coverage. The IOM has recommended to the Department of Health and Human Services (HHS) eight categories of women's health care — including contraceptives — that should be classified as preventive services and therefore available under the health care law without co-pays or cost-sharing.

According to The Hill, "The IOM said, 'the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling' should be covered for 'all women with reproductive capacity.'"

This is a huge step forward for women's health, particularly considering the anti-woman political climate the country finds itself in these days. As Vanessa Cullins, vice president for medical affairs at Planned Parenthood Federation of America, writes in a New York Times op-ed: 

The change is overdue. Cost often determines whether a woman is able to choose and maintain her most appropriate method of birth control, especially during hard times. One in three women voters have struggled to pay for prescription birth control at some point, and have used it inconsistently as a result, a survey commissioned by Planned Parenthood found last year. That's one reason our country has such high rates of unintended pregnancy and abortion.

Nearly half of all pregnancies in the United States are unplanned, but affordable contraception can change that. One study found that as the proportion of unmarried women at risk of unintended pregnancy who used contraceptives increased — to 86 percent in 2002 from 80 percent in 1982 — the abortion rate for the same group fell, to 34 per 1,000 women in 2000 from 50 per 1,000 in 1981.

Not only does the IOM recommendation lessen the cost women face, but affordable contraceptives also improve women's health. The National Women's Law Center points out, "Planned pregnancies — which for most women require contraception — improve women's health. The ability to determine the timing of a pregnancy can prevent a range of pregnancy complications that can endanger a woman's health, including gestational diabetes, high blood pressure, and placental problems, among others. An unintended pregnancy may have significant implications for a woman's health. A preexisting health condition such as diabetes, hypertension, reflux esophagitis, lower extremity or lumbar arthritis, and coronary artery disease, may be worsened by a pregnancy."

In additional to contraceptives being included as preventive services, the IOM also recommended: coverage for annual HIV tests and counseling for sexually active women, annual counseling on other sexually transmitted diseases, testing for HPV for women over 30, screenings for gestational diabetes in pregnant women, breastfeeding support, supplies and counseling, annual well-woman preventive care visits, and screenings and counseling for domestic violence. 

And while the IOM recommendations still need to be reviewed by HHS Secretary Kathleen Sebelius, Politico Pro notes that the recommendations "will likely become the minimum acceptable standard for insurance companies that want to sell on the online insurance marketplaces."