JONATHAN COHN AUGUST 1, 2011
No, that headline is not link bait. It’s breaking news.
On Monday the Obama Administration announced that it would require health insurance plans to cover a variety of preventative services for women – basically, everything from screening for gestational diabetes to counseling on domestic violence. And despite the opposition of conservative groups, that list of services will include birth control, even the controversial Plan B pill that women can shortly after intercourse in order to prevent pregnancy.
By issuing this regulation, Obama’s Department of Health and Human Services was embracing, almost to the letter, recommendations of non-partisan Institute of Medicine. It did establish one exception, exempting from the rule religious institutions that provide insurance for employees, although conservative groups say the exception is too narrow – and are asking Congress to repeal, or at least modify, this rule by law.
The rule may contain some loopholes. I haven’t had time to examine it that carefully and assume, for example, that a "grandfather" clause exempts older plans from meeting the new standard. Even so, insurer behavior will change
– and that's a good thing. Studies have repeatedly shown that, in general, high out-of-pocket costs discourage the use of medical care. And discouraging the use of preventative care is a terrible idea. Yes, it costs a lot to screen everybody for HPV. It also costs a lot to treat even a handful of people with advanced cervical cancer. And that’s to mention the fact that, without screening, a lot of those people will die.
As for birth control, there’s ample evidence that out-of-pocket expenses discourage their use. Much of it comes from states that expanded coverage of contraception through their Medicaid programs, reducing the numbers of unplanned pregnancies – and, by the way, saving taxpayer dollars, although that’s not the only or even the most important goal of this rule. Making contraception more readily available can help women space out pregnancies, for personal economic or health reasons. And, of course, it can give them more autonomy.
Props to the Obama Administration -- and to Obamacare. That maligned, under-appreciated law is what made this progress possible.