In a committee opinion released Monday by ACOG's Committee on Health Care for Underserved Women, the group offers 18 new or revised suggestions that include fully implementing the Affordable Care Act's (PL 111-148) contraceptive coverage rules, which require most employers to cover FDA-approved contraceptives in their employer-sponsored health plans (Winfield Cunningham, "Pulse," Politico, 12/23).
Specifically, the opinion calls for "[f]ull implementation of the [ACA's] requirement that new and revised private health insurance plans cover all [FDA]-approved contraceptives without cost sharing, including nonequivalent options from within one method category," as well as "[e]asily accessible alternative contraceptive coverage" for women with health plans through employers or insurers that do not offer it directly (ACOG committee opinion, 12/22).
Barriers to Contraceptive Access
The opinion, which will be published in January's edition of Obstetrics and Gynecology, highlights several recent developments that have limited women's access to contraceptives, including the Supreme Court's decision in Burwell v. Hobby Lobby, which allowed certain for-profit companies to exclude contraceptive coverage from their health plans; states' efforts to weaken laws that protect contraceptive access; and 20 states' restrictions on minors' ability to consent to contraceptive services.
Further, the committee notes that more than 18 million U.S. women who needed contraceptives in 2010 were in need of publicly funded services to access them because they were either under age 20 or had incomes below the federal poverty level.
The committee's recommendations include greater access to contraceptives for women whose health plans do not include contraceptive coverage; educational programs that are age appropriate and medically accurate; timely referrals to appropriate care from providers who do not offer contraceptive care; and payment and practice policies that allow providers to offer three- to 13-month supplies of hormonal contraceptives (Medscape, 12/23).
In addition, the committee recommends that all states expand their Medicaid programs under the ACA and that all payer and hospital formularies include all contraceptive methods ("Pulse," Politico, 12/23).
ACOG Committee on Health Care for Underserved Women Chair Wanda Nicholson said, "There have been some legal steps taken to try to restrict access, but the overall importance for improving access to contraception is the health of women, as well as being able to decide when to get pregnant." She added that the committee continually assesses and reevaluates its recommendations "as new technology and new issues arrive."
Nicholson continued, "Over the course of the last year, there has been tremendous discussion around access to family planning services, in particular access to contraception." She noted that women's ability to access contraception affects both public health and the economy, adding, "We need to take deliberate steps to ensure access and to increase and maintain open access to contraceptive methods for all women" (Medscape, 12/23).