Birth control coverage required in U.S. health plan

Back to TopCommentsE-mailPrintBookmark and Share

Health insurers led by WellPoint Inc. would be required to cover birth control pills and devices at no cost to patients under the recommendation of a top U.S. scientific advisory board.

An Institute of Medicine panel said Tuesday the government should deem birth control a preventive health service for women of reproductive age. Under the 2010 health-care overhaul, insurers have to cover certain preventive services recommended by the government without requiring co-payments or other cost-sharing by patients.

The panel in a report urged the government to require coverage of "the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures and patient education and counseling” for women who can reproduce.

Insurers have never been told to cover contraceptives such as Warner Chilcott Plc’s Loestrin 24 Fe and Merck & Co. Inc.’s NuvaRing. The products are often too expensive even when they are covered, said Judy Waxman, vice president for health and reproductive services at the National Women’s Law Center in Washington. Alternatives to the pill such as intrauterine devices, or IUDs, costing about $600, often aren’t covered at all, she said.

The recommendation “is an important public health measure that will produce healthier babies and healthier moms,” Waxman said.

Loestrin 24 Fe is the top-selling birth control pill in the U.S. with $533 million in 2010 sales, according to data from IMS Health, a Norwalk, Conn., health-consulting firm. NuvaRing is the top-selling birth control device, with sales of $412 million. The top-selling IUD, Bayer AG’s Mirena, had $348 million in sales.

Birth control would have to be covered for free by insurers offering new plans in 2013 under the recommendation before Health and Human Services Secretary Kathleen Sebelius, Waxman said. Plans that are considered “grandfathered” under the health-care law wouldn’t have to comply.

Sebelius said in a statement that her department would review the recommendation and “very soon” issue required preventive services.

“This report is historic,” she said. “Before today, guidelines regarding women’s health and preventive care did not exist.”

Health plans already encourage customers to seek preventive care recommended by independent authorities, and requiring insurers to cover additional services such as birth control may raise costs, said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, a trade group in Washington, D.C.

“Broadening the scope of mandated preventive services that go beyond or conflict with the current evidence-based guidelines will increase the cost of coverage for individuals, families, and employers,” he said in an e-mail.

Planned Parenthood said insurance co-payments for birth control typically cost $15 to $50 a month.

The recommendation would mean opponents to the use of birth control would still have to buy insurance that covers it, said Jeanne Monahan, director of the Center for Human Dignity at the Family Research Council, a Christian nonprofit in Washington.

Her group also doesn’t want emergency contraceptives that she said can be used to abort a pregnancy, such as over-the- counter emergency contraceptive Plan B, included among birth control products that are required to be covered.

“The real issue is less about birth control as such; it’s rather about specific contraceptives that can function as” substances that induce abortion, she said.

Linda Rosenstock, the dean of the University of California Los Angeles School of Public Health and the chairwoman of the Institute of Medicine panel, said the group wasn’t directed to consider “personal beliefs” in its work.

“Our charge was to look at the evidence for the effect of services,” she said by phone. “There’s very strong evidence that unintended pregnancy carries adverse consequences for the mother as well as the child.”

The Institute of Medicine panel also recommended that the government require coverage of testing for HIV and human papillomavirus, or HPV, another sexually transmitted disease; screening and counseling for domestic violence; breast-feeding counseling and equipment; and gestational diabetes, common to pregnant women.

One of the 16 members on the panel dissented from the report in an uncommon action, said Christine Stencel, a spokeswoman for the National Academies.

Anthony Lo Sasso, a professor at the University of Illinois at Chicago’s School of Public Health, said the panel shouldn’t have made any recommendations because its work was rushed and there was little scientific evidence the services lead to “lower rates of disability or disease and increased rates of well-being” among women.

“The recommendations were made without high-quality, systematic evidence of the preventive nature of the services considered,” he wrote. In a response, the other 15 panel members wrote that “no other member shares the opinion that report recommendations were not soundly evidence-based.”

Sebelius, too, said the report was based on “science and existing literature.”

Rosenstock said that the rest of the panel felt there was “adequate time” to deliberate and that Lo Sasso wanted the recommendations to weigh the cost of preventive services.

“We were asked not to consider cost as part of our considerations,” Rosenstock said.



  • Ben
    Ben - I appreciate your views. You would have to agree that implantation prevention is only a backstop if the other 2 methods fail, correct? Therefore it is not the primary means by which HBC works.

    I cannot provide any evidence that HBC causes long-term side effects such as impaired fertility, but I also cannot find any evidence of the long-term side effects of using HBC. The admittedly antecdotal experiences of my friends and family suggest that after years and years of using HBC, female's reproductive system may need to be shocked into remembering how to function properly with (drumroll....) more pharmaceuticals and countless visits to OBGyns and specialists.

    My only angle here is that people need to think more critically before popping every pill that their doctor suggests. Perhaps the benefit outweighs the costs when it comes to HBC. Not sure, but buyer beware.
  • birth control

    The link you posted says that it works by both mechanisms:


    It states in part:

    "Pregnancy is prevented by a combination of factors. The hormonal contraceptive usually stops the body from releasing an egg from the ovary. Hormonal contraceptives also change the cervical mucus to make it difficult for the sperm to find an egg. Hormonal contraceptives can also prevent pregnancy by making the lining of the womb inhospitable for implantation."

    which implies that although it typically prevents the release of an egg or fertilization, it also works by preventing implantation in at least some cases.

    Hormonal birth control is controversial in some circles that worry about every fertilized egg in all situations (I am not in this group). For example,

    I couldn't find any evidence that hormonal birth control reduces the chance of later conception beyond a few months after stopping the treatment. Can you provide any non-anecdotal evidence? My peers (late 20s early 30s) who have gone off of HBC seem to be having plenty of kids without issue but that doesn't prove anything.

    HBC is widely used and side effects have been studied extensively. For example,
    it seems to increase the risk of a blood clot and there is some disagreement about if it increasing the risk of breast cancer.

  • know more than you
    jane, jane, jane....please get educated. Most birth control DOES work by blocking ovulation. If it worked by stopping a fertilized egg from implanting, I am guessing it would be a wee bit more controversial, don't you?


    As you say, there has been a lot of research on birth control, but it has all been on its effectiveness, not its side effects. If you take birth control, you are risking your bodies ability to know what to do on its own later. Think about it, your body gets dependent on the artificial hormone treatment just like your body gets dependent on any drug.

    There is too much money in birth control and fertility treatments for anyone to look into this.
  • Little knowledge
    Shows what little knowledge you have of birth control - it doesn't stop ovulation, it stops the egg from being implated. People can have all types of trouble having a baby wehn they didn't even use birth control. Don't blame something that has had hundreds and hundreds of hours of research when you don't even know how it works.
  • long term impact?
    It is no coincidence that so many people that have taken birth control for years / decades have difficulty with getting pregnant when they are ready. You cannot have a drug block ovulation for 10 years and then just expect your body to work perfectly at the flip of a switch. Much research needs to be done.
    • About Time!
      For years insurers have covered Viagra for men. It's about time that they also covered birth control it is a small cost to pay for an unwanted pregnancy. We see it all to often people who don't or shouldn't have children get pregnant. Unfortunate but true many of these children become abused and or dead. Living with the thought that they were unwanted or unloved. Not that this always is the case but lets at least get with the times and realize this does happen and do what we can to prevent it!
    • Birth control coverage
      I'm to old now it should have been in place
      a long time ago!!

    Post a comment to this story

    We reserve the right to remove any post that we feel is obscene, profane, vulgar, racist, sexually explicit, abusive, or hateful.
    You are legally responsible for what you post and your anonymity is not guaranteed.
    Posts that insult, defame, threaten, harass or abuse other readers or people mentioned in IBJ editorial content are also subject to removal. Please respect the privacy of individuals and refrain from posting personal information.
    No solicitations, spamming or advertisements are allowed. Readers may post links to other informational websites that are relevant to the topic at hand, but please do not link to objectionable material.
    We may remove messages that are unrelated to the topic, encourage illegal activity, use all capital letters or are unreadable.

    Messages that are flagged by readers as objectionable will be reviewed and may or may not be removed. Please do not flag a post simply because you disagree with it.

    Sponsored by

    facebook - twitter on Facebook & Twitter

    Follow on TwitterFollow IBJ on Facebook:
    Follow on TwitterFollow IBJ's Tweets on these topics:
    Subscribe to IBJ
    1. Uh, sorry Johnnie, but you are incorrect. Despite the assertions by yourself and various defenders and captains, sports attendance is NOT off significantly at most sporting events in the US. Variances in attendance has been in the range of single digits, both + & - for years now. MLB has had most of its best overall attendance nubers in the last decade, and that trend has been consistent for most major sporting events. The number one issue cited by most fans when asked about attendance is the overall cost of attending. The presence of HD and big screen televisions in home doesn't even register, as a factor for not attending an event. VALUE in the product is the key, and apparently is something lacking in the current ICS. What other explanation is there when with what is routinely touted as the "best" racing on the planet, fans are staying away in DROVES. A "close" title battle into the last event at Fontana, with the "cars and stars" of the ICS, and who showed up? MAYBE 8K. Sorry, but HD TV isn't to blame for that kind of fan apathy.

    2. Do you need finance to establish your business ? Are you interested in getting a loan at 3% from our private company? If so please Email: suntrust_oil@blumail.org

    3. If she was worth the $ the public outcry over direct tv dropping them would have kept them on their dishes as we have seen with other companies. I too quit watching channel 13 after she showed up since I left channel 8 because of her all show rather than production results. When Randy on 8 corrected her she had a big head and incorrectly challenged his correction for pronunciation of a city. Other antics while she matures was too much for me with her very inaccurate forecasts. All the forecasters were predicting rain until Thursday except Chris. They predicted sunny on Thursday but instead of rain until Thursday upon which the sun would finally make it out in full glory Chris was right on the money just as I too predicted looking at the radar on weather.gov. One thing I love about Angela is the fear you can see in her every time it thunders in the winter. It far exceeds the entertainment value of her body language (high heel noise drags, depression, etc) when her forecasts are so incorrect. Her hair stands on end, you have to see it!!!

    4. Good Day, Apply For A Loan I am Mr Fernadez Antonio, a private Loan lender and a cooperate financial for real estate and any kinds of business financing. I also offer Loans to individuals, Firms and cooperate bodies at 3% interest rate We offer any kind of loans. email us via fernadezloaninvest@outlook.com LOAN APPLICATION FORM First name:......................... Middle name:......................... Last name:........................................ Date of birth (yyyy-mm-dd):....................... Gender:........................................... Marital status:................................... Total Amount Needed............................... Loan Duration.................................... Address:.......................................... City:............................................. State/province:................................... Zip/postal code:.................................. Country:.......................................... Phone:............................................ Fax:.............................................. Mobile/cellular:.................................. Monthly Income.................................... Occupation:....................................... Best Regard, Mr Fernadez Antonio.

    5. i will love to share my testimony to you all the people in world i got married to my husband about 2 year ago we start having problems at home like we stop sleeping on the same bed,fighting about little things he always comes home late at night,drinking too much and sleeping with other women out side i have never love any man in my life except him. he is the father of my child and i don't want to loose him because we have worked so hard together to become what we are and have today .few month ago he now decided to live me and the kid,being a single mother can be hard sometimes and so i have nobody to turn to and i was heart broken.i called my mom and explain every thing to her,my mother told me about DR.okoro how he helped her solve the problem between her and my dad i was surprise about it because they have been without each other for three and a half years and it was like a miracle how they came back to each other. i was directed to DR. okoro on his email:okorospell@gmail.com and explain everything to him,so he promise me not to worry that he will cast a spell and make things come back to how we where so much in love again and that it was another female spirit that was controlling my husband he told me that my problem will be solved within two days if i believe i said OK So he cast a spell for me and after two days my love came back asking me to forgive him i Am so happy now. so that why i decided to share my experience with every body that have such problem contact Dr okoro the great spell caster on his email addresses spellcasterforlove@outlook.com