March 1, 2012

GOP Attempt to Quash Contraception Coverage Fails for Now But Begs the Question: What if There Were 83 Women Senators?

By a close vote of 51 to 48, the Senate today blocked a measure that would have allowed employers and health insurance companies to deny coverage for contraceptives and other medical services for any religious or moral objection.

The vote was on an amendment proposed by Republican Sen. Roy Blunt of Missouri, who sought to insert the largest political wedge possible between an individual and her doctor. The amendment would have allowed employers and insurers to refuse to cover “specific items or services” if coverage would be “contrary to the religious beliefs or moral convictions of the sponsor, issuer or other entity offering the plan.” Here’s how that proposal could have played out, as well as the effect it may have had on the LGBT community.

The amendment was in response the current debate over the president’s plan to mandate coverage, with no co-pay, for health services the independent Institute of Medicine categorizes as “preventive” — including contraception.

Republicans balked at the compromise President Obama put forth last month in an effort to address concerns, raised loudly by the U.S. Conference of Catholic Bishops, that nonprofit church-affiliated organizations, such as hospitals and universities, shouldn’t be forced to provide birth control coverage to employees — even though those organizations receive public funding and employ people of all faiths. (Churches and other explicitly religious organizations were already exempt.) Under the work-around, insurers would directly cover contraception. Critics were not appeased.

According to a tracking poll released today by Kaiser Family Foundation, 6 in 10 Americans, including Catholics, support requiring health plans to supply free contraceptives as a preventive benefit for women.

The debate today was heated, with many Democrats displaying frustration that the country seems stuck in a half-century old debate about birth control. Sen. Bernie Sanders of Vermont summed up the crux of the problem quite well:

“This attack is grossly unfair, and I hope that men will stand with women in the fight to protect this very basic right. Let me add my strong belief that if the United States Senate had 83 women and 17 men rather than 83 men and 17 women that a bill like this would never even make it to the floor.”

Plus: Some Republicans seem shocked (shocked!) that contraception is considered a preventive health care service. For an in-depth look at why this is the case, take a look at this article by Adam Sonfield that appeared in the Spring 2010 edition of Guttmacher Policy Review. Here’s an excerpt:

[...] Healthy People 2010, describes the importance of family planning services in terms of preventing the social, economic and medical costs of unintended pregnancy. In this context, it is the medical costs that are most relevant: “Medically, unintended pregnancies are serious in terms of the lost opportunity to prepare for an optimal pregnancy, the increased likelihood of infant and maternal illness, and the likelihood of abortion.…The mother is less likely to seek prenatal care in the first trimester and more likely not to obtain prenatal care at all. She is less likely to breastfeed and more likely to expose the fetus to harmful substances, such as tobacco or alcohol. The child of such a pregnancy is at greater risk of low birth weight, dying in its first year, being abused, and not receiving sufficient resources for healthy development.”

The CDC cites similar reasons for its own work to prevent unintended pregnancy and for labeling family planning as one of the top 10 public health achievements of the 20th century. And, indeed, there is clear evidence that contraception is effective preventive care. For example, publicly funded contraceptive services and supplies alone help women in the United States avoid nearly two million unintended pregnancies each year. In the absence of such services (from family planning centers and from doctors serving Medicaid patients), estimated U.S. levels of unintended pregnancy, abortion and unintended birth would be nearly two-thirds higher among women overall and nearly twice as high among poor women. The evidence is just as clear internationally: In 2008, use of modern contraceptives helped women prevent 188 million unintended pregnancies and, by doing so, prevented some 1.2 million newborn deaths and 230,000 maternal deaths and saved tens of millions of years of productive life (related article, page 12).

It is no surprise, therefore, that family planning was one of the five priority areas listed under “preventive health services” in the first Healthy People in 1979 and has been a focus area in every edition.

The link contained within this excerpt leads to another excellent article, “Family Planning and Safe Motherhood: Dollars and Sense,” that provides more of a global overview. For a concise summary of the key benefits worldwide, view Secretary of State Hillary Clinton’s testimony this week on U.S. funding for international family planning.

Here’s the key takeaway from Clinton: “Global estimates indicate that by helping women space births and avoid unintended pregnancies, family planning has the potential of preventing 25 percent of the maternal and child deaths in the developing world. Family planning is the best way we have to prevent unintended pregnancies and abortion.”


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