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Davis, California

Monday, February 26, 2024

Debate over contraceptive coverage rages

The Affordable Care Act (ACA), a set of comprehensive reforms aimed at improving access to health care coverage and protection from abusive insurance company practices, was signed into law on March 23, 2010.

Nearly two years later, House Rep. Darrell Issa (R–CA) summoned a House Oversight Committee to investigate his questioning of the health care act. The congressperson asked, “Has the Obama Administration trampled on freedom of religions and freedom of conscience” with the enacting of the bill?

The section of the act responsible for Issa’s inquiry is that which is concerned with contraceptive coverage. All churches and houses of worship are exempt from the mandated contraceptive coverage which extends to employers and educational institutions. However, what Issa alludes to is the stipulation that all new health insurance plans formulated and emplaced following Aug. 1, 2012 are mandated to provide contraceptive coverage, including those used for enterprises owned by religious organizations — such as hospitals and schools.

The nonprofit, non-governmental Institute of Medicine suggested the regulations as medically necessary “to ensure women’s health and well-being.”

Religious organizations that oppose the use of contraceptives, such as the Catholic Church, have championed for the elimination of the Aug. 1 implementation. The Administrative Committee of the United States Conference of Catholic Bishops released a statement in direct contestation with the particular section of the ACA.

“Indeed, this is not about the Church wanting to force anybody to do anything; it is instead about the federal government forcing the Church … to act against Church teachings,” the Committee said.

Apart from contention on the basis of religious grounds, others, notably and most recently conservative talk show pundit, Rush Limbaugh, have blasted coverage of contraceptives citing their expense. Dr. Michelle Famula, executive director of UC Davis’ Health and Wellness Center, explained that estimates in cost for an unplanned pregnancy far exceed the financing of contraceptive pills.

For example, the routine delivery at most hospitals averages anywhere from $6,000 to $8,000. In addition, another $2,000 is added for uncomplicated prenatal care — while contraceptive pills run $40 to 60 per pack.

“Looking at it another way, it is 10 times more expensive a year for every unintended, unprevented pregnancy,” Famula said.

The act grants individual states the alternative to continue enforcement of their own state benefit mandates. Among her areas of focus, UC Davis law professor Lisa Ikemoto, specializes in public health law and reproductive rights. She explains that the above stipulation could have significant overarching ramifications.

“What may very well happen now is that state legislatures will jump on the bandwagon and enact state laws that either exempt employers and insurers from providing contraceptive coverage, or that will actually prohibit employers and insurers from providing contraceptive coverage,” Ikemoto said.

Unlike Viagra and other erectile dysfunction drugs which serve no alternative health purposes and have yet to come under attack by any religious organizations, birth control has been defined within the ACA as preventative health care. The contraceptive can be used to prevent diseases of the reproductive tract, dysfunctional uterine bleeding, ovarian cysts, endometriosis and preserve future fertility for women with hormone imbalances.

“It is my perspective that accessible contraception is critical to women’s ability to take responsibility for her health and wellness,” Famula said. “Unintended pregnancy is a physical condition that has significant health and wellness implications for the pregnant woman. Proactive management of reproduction is preventive care.”

KELLEY REES can be reached at city@theaggie.org.

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