The Health and Human Services Department accepted a slate of controversial recommendations for women’s health care on Monday, issuing new regulations that will require health insurers to pay for birth-control services, breastfeeding support, and domestic violence screening and counseling.
New health insurance companies will have to fully pay for these services starting in August 2012. HHS officials said the regulations will improve health care for women and eventually save money. Public-health experts mostly agreed. But big health insurance companies said the new regulations would actually raise costs, and Catholic health care providers complained about the birth-control requirements.
The Institute of Medicine recommended the new approach last month, saying scientific studies showed that paying for these services saves money and improves health. It said insurers should pay for birth-control counseling and services; two types of cervical cancer screening – the old-fashioned Pap test and newer tests that look for the HPV virus that causes the cancer; screening for the AIDS virus and other sexually transmitted infections; breast feeding support for new mothers; and domestic violence screening and counseling.
“Today we are accepting them so that no woman in America has to choose between paying the grocery bill and paying the co-pay for care that could save her life,” HHS Secretary Kathleen Sebelius told reporters in a conference call.
“If 90 percent of mothers were able to breast feed in first six months, it would save the lives of thousands of infants and save the health care system $13 billion each year.”
The 2010 health care law already requires insurers to cover preventive services such as mammograms, colonoscopies, blood pressure checks, and childhood immunizations without charging a copayment or deductible.
HHS’s Dr. Howard Koh said the new regulations expand on these requirements. “On average, women need to use more preventive services than men, yet women typically earn lower incomes than men and are often less able to pay. So it is less surprising that women are more likely than men to forgo certain services because of cost,” Koh told the briefing.
Families USA Executive Director Ron Pollack praised the move.
“Each of these services is shown to be highly effective at preventing bad health outcomes for women and children, while improving health and well-being and reducing the need for high-cost care,” he said. “This is a triumph of public-health policy and common sense over politics.”
The rules apply only to new insurance companies, not existing, grandfathered providers, HHS said. Koh estimated that 34 million women aged 18 to 64 would be covered under new plans expected to come into existence under the 2010 health care law by 2013.
Karen Ignagni, CEO and president of America’s Health Insurance Plans, argued that the new regulations “would increase the number of unnecessary physician office visits and raise the cost of coverage.” She said the recommendations go beyond current guidelines and would encourage patients to get prescriptions for routine, over-the-counter supplies.
The U.S. Conference of Catholic Bishops objected to the way HHS tackled the issue of birth control. The Roman Catholic Church, a major provider of health care, opposes the use of artificial contraception.
HHS exempts religious employers from covering contraceptive services, but the exemption only applies to group plans offered by religious employers. To qualify as a religious employer, the group must be a nonprofit and mainly employ and serve people who share the same religious beliefs.
"Although this new rule gives the agency the discretion to authorize a 'religious' exemption, it is so narrow as to exclude most Catholic social-service agencies and health care providers," Cardinal Daniel DiNardo, archbishop of Galveston-Houston, said in a statement from the Conference of Catholic Bishops.
"For example, under the new rule our institutions would be free to act in accord with Catholic teaching on life and procreation only if they were to stop hiring and serving non-Catholics," he added. "Could the federal government possibly intend to pressure Catholic institutions to cease providing health care, education and charitable services to the general public?"
Althea Fung, Meghan McCarthy