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Debate erupts over federal recommendation on free birth control

Free birth control for women could be available soon if the U.S. Department of Health and Human Services follows an advisory panel's recommendations. While women's health advocates are cheering this development, health insurers and anti-abortion groups are insisting the free care would unfairly drive up insurance costs for everyone.

In a new report, a panel of the National Academy of Sciences’ Institute of Medicine says there should be no out-of-pocket insurance deductibles or co-pays for any FDA-approved birth control drugs or sterilization procedures provided through most private health insurance plans. Public insurance programs like Medicaid wouldn't be affected.

Currently, insured women must pick up some of the costs for those drugs and procedures. Birth control pills, for example, typically cost $15 to $50 a month, according to the nonprofit Planned Parenthood Federation of America, which praised the panel's recommendations. Planned Parenthood offers women's health care services, including abortions.

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Planned Parenthood: 'Tremendous stride forward'

“Millions of women, especially young women, struggle every day to afford prescription birth control,” Cecile Richards, president of Planned Parenthood, says in a statement. “(The) 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.”

The Department of Health and Human Services is expected to decide on the panel's recommendations as early as August. Any changes stemming from the recommendations likely would take effect in 2013.

The Institute of Medicine panel was asked to determine which preventive services for women should be covered by most private health insurance plans -- without co-pays or deductibles -- as part of the federal health care reform law.

NARAL Pro-Choice America: Major advancement

Nancy Keenan, president of NARAL Pro-Choice America, says in a statement that nearly one in three American women has difficulty paying for birth control. NARAL is a nonprofit group that supports abortion rights. Keenan says that making family planning services more accessible will reduce the number of unintended pregnancies -- and, therefore, abortions.

“As someone who has worked on women’s rights for nearly 30 years, I can say that (this) news marks one of the biggest advances for women’s health in a generation,” Keenan says of the panel's recommendations.

The panel's report also recommended other women's health services that should be provided without insurance co-pays or deductibles, such as:

• Screening for pregnancy-related diabetes.

• Testing for the human papillomavirus (HPV), which can cause cervical cancer.

• Yearly counseling about sexually transmitted infections for sexually active women.

• Yearly HIV counseling and screening for sexually active women.

• Rental of breastfeeding equipment.

• Domestic violence counseling.

• Annual "well woman" preventive care.

Insurance industry: Costs will rise

Robert Zirkelbach, a spokesman for America's Health Insurance Plans, says health insurers already emphasize preventive care. America's Health Insurance Plans is a trade group for the health insurance industry. Preventive care guidelines are based on recommendations from independent organizations such as the Advisory Committee on Immunization Practices and the U.S. Preventive Services Task Force, he says.

“Broadening the scope of mandated preventive services that go beyond or conflict with the current evidence-based guidelines will increase the cost of coverage for individuals, families and employers,” Zirkelbach says.

Family Research Council: Abortion would be 'mandated'

The recommendation to add the full range of FDA-approved contraceptives, including two "emergency" medications, drew swift opposition from groups such as the Family Research Council and the United States Conference of Catholic Bishops.

The Family Research Council, a Christian lobbying group, says the two emergency contraceptives -- the "morning after" Plan B and another pill known as “ella” -- kill human embryos. Therefore, the council says, the panel's recommendations would “mandate” coverage for abortion.

RU-486, known as "the abortion pill," was not included in the panel's recommendations.

If the Department of Health and Human Services embraces the panel's suggestions, "the conscience rights of millions of Americans will be violated, including issuers of plans, providers who contract with such plans, and Americans who will pay for the cost of these services,” Jeanne Monahan, director of the Family Research Council's Center for Human Dignity, says in a statement.

In a statement, Cardinal Daniel DiNardo of Galveston-Houston, chairman of the Committee on Pro-Life Activities of the United States Conference of Catholic Bishops, urges the Department of Health and Human Services "to focus on the need of all Americans, including immigrants and the poor, for basic life-saving health coverage – not on mandating controversial elective practices in ways that undermine the good of women and children, the consciences of employers, employees and health plan providers, and the common good."

Panel member: 'Underserved' women will benefit

Members of the federal panel say one of their goals was to figure out ways to prevent unintended pregnancies, which make up about half of all U.S. pregnancies. According to the panel's report, women with unintended pregnancies are more likely to receive no or delayed prenatal care, drink alcohol, smoke cigarettes, suffer from depression and be victimized by domestic violence.

Panel members believe the free preventive care will be crucial for minority women.

“Without a doubt, underserved women and women of color tend to have greater barriers to accessing particularly services with co-pay… these recommendations are particularly important for those women,” says Dr. Paula Johnson, chief of the Division of Women's Health at Brigham and Women's Hospital in Boston.

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