Religious Freedom and Women's Health — The Litigation on Contraception (New Eng Jour Med)
Religious Freedom and Women's Health The Litigation on Contraception
Timothy Stoltzfus Jost, J.D.
December 19, 2012
Health policy experts widely agree that health care should not merely be sickness care; rather, it should actively prevent disease and preserve wellness. Not surprisingly, therefore, the Affordable Care Act (ACA) contains an entire chapter dealing with prevention and public health. The ACA also improves private and public insurance coverage of preventive care. One preventive care requirement, however, has caused a major headache for the Obama administration. Indeed, it has provoked charges that the administration is waging a war on religion.
The ACA requires private insurers and group health plans (except for grandfathered plans, defined as those that existed at the time the ACA became law and have not significantly changed) to cover preventive services without cost sharing by enrollees. This provision does not list the covered services, instead referencing the recommendations of other federal agencies that deal with prevention. It specifically requires coverage of women's preventive care and screening services provided for in comprehensive guidelines supported by the Health Resources and Services Administration (HRSA).
At HRSA's request, the Institute of Medicine (IOM) identified women's preventive services that should be covered. On August 1, 2011, HRSA released guidelines based on the IOM's recommendations. Among the services that health plans and insurers must cover are all Food and Drug Administrationapproved contraceptive methods. Coverage must be available for plan years beginning after August 1, 2012.
Requiring contraception coverage is not a radical innovation. Twenty-eight states currently require insurers (with some exceptions) to cover contraceptives. The Equal Employment Opportunity Commission has also concluded that contraception coverage is required by the Pregnancy Discrimination Act, although federal courts have come to contradictory conclusions on this question. But contraception is considered to be a grave sin by the Roman Catholic church, and a number of Protestant organizations object specifically to morning after contraceptives and intrauterine devices, which they consider to be abortifacients.
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http://www.nejm.org/doi/full/10.1056/NEJMp1214605?query=TOC