U.S. women may receive selected, free preventive services the next time they visit the doctor's office, as the Institute of Medicine (IOM), has recommended that the federal government consider making free birth control available to support women's health.
Last year, the U.S. Department of Health and Human Services (HHS), tasked the IOM to review what preventive services are important to women's health and wellbeing. HHS also asked the IOM to recommend which of those services should be considered when developing comprehensive guidelines.
The IOM team identified eight services to help fill the gap in the HHS list of services for women's health to include coverage of contraceptives.
In a report released Tuesday, titled Clinical Preventive Services for Women: Closing the Gaps, the IOM recommends the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.
If women are afforded these services, they can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes, according to the authors of the report.
Women stand to benefit from this shift given their longer life expectancies, reproductive and gender-specific conditions, and historically greater burden of chronic disease and disability, the authors wrote in a report briefing.
The Centers for Disease Control and Prevention stated that back in 2001 that about half of the pregnancies in the U.S. were unintended. Such pregnancies are associated with an increased risk of morbidity. Also women with an unintended pregnancy may delay prenatal care, which can affect the infant's health, according to the CDC.
With the availability of free birth control, more women will be able to better space out the time between births.
Millions of women, especially young women, struggle every day to afford prescription birth control, said Cecile Richards, president of Planned Parenthood Federation of America. Today's recommendation brings us a step closer to ensuring that all newly insured women under the health care reform law will have access to prescription birth control without out-of-pocket expenses. This would be a tremendous stride forward for women's health in this country.
Co-pays for birth control pills can range between $15 and $50 per month, and other methods, such as IUDs, can cost several hundred dollars, even with health insurance, according to Planned Parenthood.
The Patient Protection and Affordable Care Act, or ACA, also known as the U.S. Health Care Reform Act, passed in 2010, emphasizes preventive services so that health care personnel can move away from reacting to health problem towards promoting better health attitudes.
If the HHS accepts these recommendations from the IOM, women may start seeing some economic benefits, especially those from moderate- to low-income households. These savings may occur because the ACA removes cost-sharing requirements for specified preventive services, which in turn do away with the out-of-pocket costs that often put screenings, counseling and procedures supporting health out of reach for these women, according to the report.
Health Secretary Kathleen Sebelius told CNN that the report is being closely reviewed and will be available soon.
Other recommendations from the IOM include:
- Screening for gestational diabetes in pregnant women between 24 and 28 weeks of gestation and at the first prenatal visit for pregnant women identified to be at high risk for diabetes;
- The addition of high-risk human papillomavirus DNA testing in addition to conventional cytology testing in women with normal cytology results. Screening should begin at 30 years of age and should occur no more frequently than every three years;
- Annual counseling on sexually transmitted infections for all sexually active women;
- Counseling and screening for HIV infection on an annual basis for sexually active women;
- Comprehensive lactation support and counseling and costs of renting breastfeeding equipment. A trained provider should provide counseling services to all pregnant women and to those in the postpartum period to ensure the successful initiation and duration of breastfeeding. (The ACA ensures that breastfeeding counseling is covered; however, the committee recognizes that views differ on the benefits of breasfeeing);
- Screening and counseling for interpersonal and domestic violence. Screening and counseling involve elicitation of information from women and adolescents about current and past violence and abuse in a culturally sensitive and supportive manner to address current health concerns about safety and other current or future health problems;
- At least one well-woman preventive care visit annually for adult women to obtain the recommended preventive services, including preconception and prenatal care. The committee also recognizes that several visits may be needed to obtain all necessary recommended preventive services, depending on a woman's health status, health needs, and other risk factors.