Escrito por Rachel. Traducido del orginial en inglés Aug. 1, 2011.

OBOS has received funding to make blog entries available in Spanish. We hope to expand outreach efforts in the coming year.

Hoy, el Departamento de Salud y Servicios Humanos de los Estados Unidos anunció que va a adoptar las recomendaciones del Instituto de Medicina para los servicios de cuidado preventivo para las mujeres.  Esto garantizará que las mujeres tengan acceso a los siguientes servicios bajo los planes de seguro médico, sin tener un copago, aseguro, o deducible:

• consultas para la mujer
• estudios para detectar la diabetes gestacional
• pruebas de la VPH
• asesoramiento en enfermedades de transmisión sexual
• pruebas de detección y asesoramiento de la VIH
• métodos anticonceptivos y consejería
• apoyo para el período de lactancia, provisiones y asesoramiento
• detección y asesoramiento para la violencia domestica e interpersonal

Se espera que cobertura para estos servicios empiece el 1ro de agosto del 2012.

Hay una advertencia para algunas mujeres en cuanto al acceso a los anticonceptivos sin un copago—una estipulación según la cual, “Los planes de salud de grupo que son patrocinados por ciertos empleadores religiosos, y seguros médicos de grupo que están conectados con estos planes están eximidos del requerimiento de cubrir servicios de anticonceptivos.”

Información adiciónale sobre el tema:

• Ley del Cuidado de Salud a Bajo Precio regula la expansión de acceso a servicios preventivos para mujeres – anuncio de prensa en CuidadoDeSalud.gov
• Servicios preventivos para mujeres: búsqueda de comentarios –blog en CuidadoDeSalud.gov
• Asistencia preventiva –muchos recursos sobre este tema en CuidadoDeSalud.gov

Many women may remember news about the injuries caused by the Dalkon Shield intrauterine device, a product that caused infection and other problems in many women in the 1970s. Newer, safer IUDs are now on the market, and the contraceptive method is apparently being used more and more, reportedly rising from 2.4 percent in 2002 to 5.6 percent by 2008.

CommonHealth, a blog at Boston’s NPR affiliate WBUR, explores this rise in the recent post “Why The IUD Is On The Rise (And You Might Want One).” The author, Carey Goldberg, suggests that one reason for the rise may be the convenience of the IUD as a long-acting birth control method that has less chance of user error (compared to birth control pills that you might forget to take, for example). She also explores a bit of the history of the Dalkon Shield and discusses safety concerns about IUD use.

OBOS’s own Judy Norsigian was interviewed about the IUD option (and Goldberg nicely mentions the new 40th anniversary edition of the book, due out this October). Judy explains that like any method, there are benefits and risks associated with IUD use:

“Like every method,” she said, “it has its downsides. There’s a remote risk of embedding and perforation, but it’s small. And some women have a lot of pain, others don’t. Some women expel the IUD, others don’t. But for most women who have very heavy periods, using the [Mirena] IUD results in lighter periods and decreased bleeding at menopause. So there are benefits as well. It’s one of those things where a woman has to weigh her own priorities about what matters most to her.”

Here’s a good fact sheet on the pros and cons. The CommonHealth blog has a follow-up piece today, “10 Reasons To Get An IUD, And 5 Downsides.”

As previously reported, women with health insurance will soon have access to a host of preventive health care services, including contraception, without having to pay out-of-pocket costs such as co-payments, co-insurance and deductibles.

Not surprisingly, the news rankled some conservatives who refuse to acknowledge the long-term economic or health benefits.

Take, for instance, Sandy Rios, a FOX News contributor and vice president of the Family-PAC Federal, a conservative political action committee, who likened women’s health needs to beauty services: ”We’re $14 trillion in debt and now we’re going to cover birth control, breast pumps, counseling for abuse? Are we going to do pedicures and manicures as well?”

Once again, we turn to Stephen Colbert to explain the outrage. And he does so beautifully, noting, for instance, that “a woman’s health decisions are a private matter between her priest and her husband,” and insurance companies should be in the business of covering only “necessary medical expenses — like boner pills.”

Plus, learn what happens when U.S. women get their hands on birth control pills …

Today, the U.S. Department of Health and Human Services announced that it is adopting the Institute of Medicine’s recommendations for preventive care services for women. This will ensure that women have access to the following services under health insurance plans without having to pay a co-payment, co-insurance or deductible:

• well-woman visits
• screening for gestational diabetes
• HPV testing
• STI counseling
• HIV screening and counseling
• contraception methods and counseling
• breastfeeding support, supplies, and counseling
• screening and counseling for domestic and interpersonal violence

Coverage for these services is expected to begin Aug. 1, 2012.

There is one caveat for some women regarding access to contraception without a co-pay — a provision that “Group health plans sponsored by certain religious employers, and group health insurance coverage in connection with such plans, are exempt from the requirement to cover contraceptive services.”

An announcement at the HealthCare.gov site indicates that public comment is welcome on this provision. Although I haven’t yet been able to locate it on Regulations.gov, instructions for comment and more detail about the exemption is provided in this document.

Publicado por Rachel / del orginial en inglés July 20, 2011

OBOS has received funding to make blog entries available in Spanish. We hope to expand outreach efforts in the coming year.

¡Buenas noticias! Tal vez recuerda que la ley de reforma para el cuidado de la salud suscrita el año pasado incluía términos sobre servicios de salud preventiva que debían ser completamente cubiertos, sin requerir un copago de los pacientes.

Sin embargo, no estaba claro si el control de la natalidad iba a ser incluido como servicio preventivo.  A nosotros nos parece obvio, pero se solicitó al Instituto de Medicina que presente recomendaciones en cuanto a los servicios preventivos para la salud de las mujeres que debían ser incluidos. Ellos incluyeron el control de la natalidad en las recomendaciones que publicaron ayer.

Si esta propuesta es adoptada, los servicios preventivos, incluyendo el control de la natalidad, podrían ser mucho más asequibles y accesibles para las mujeres en los Estados Unidos.

Después de revisar la tasa y las consecuencias de los embarazos no planeados, la eficacia del control de la natalidad y las preocupaciones sobre costo y acceso, el Instituto concluyó:

El comité recomienda que se consideren como servicios preventivos para mujeres: La amplia selección de métodos anticonceptivos aprobados por la Administración de Alimentos y Fármacos (FDA), procedimientos de esterilización, y educación y consejería del paciente para todas las mujeres con capacidad de reproducir.

Además de la cobertura para el control de la natalidad sin tener que hacer un copago, el Instituto recomienda:

• estudios para detectar la diabetes gestacional
• pruebas para la virus del papiloma humano (VPH) como parte de los estudios para detectar el cáncer de cuello uterino para mujeres mayores de 30 años
• asesoramiento en enfermedades de transmisión sexual
• asesoramiento y pruebas de detección del VIH
• asesoramiento de lactancia y equipo para promover el amamantamiento
• asesoramiento y pruebas para detectar y prevenir la violencia domestica e interpersonal
• visitas anuales de cuidado preventivo para mujeres a fin de obtener una recomendación de servicios preventivos

Información adiciónale sobre el tema:

• Declaración –de “March of Dimes” elogiando las recomendaciones
• Los Principales Defensores Latinos Nacionales Instalan al Presidente a Rechazar la Arrolladora Expansión de la Clausula de Rechazo de los Anticonceptivos – del Instituto Latino Nacional para la Salud Reproductiva
• Grupo de médicos recomienda entrega gratuita de anticonceptivos – de Univision.com

Good news! You may remember that the health care reform legislation enacted last year included provisions for preventive health care services to be fully covered without requiring patients to have copayments.

It was not clear, however, whether birth control would be included as a preventive service. It seems obvious to us, but the Institute of Medicine was asked to make some recommendations about which preventive services for women should be included, and included birth control in those recommendations, released yesterday.

If they are adopted, preventive services including birth control could become much more affordable and accessible to women in the United States.

The Institute, after reviewing the rate and consequences of unintended pregnancy, effectiveness of birth control, and cost and access concerns, concluded:

The committee recommends for consideration as a preventive service for women: the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity.

In addition to copay-free coverage of birth control, the Institute recommended:

• screening for gestational diabetes
• human papillomavirus (HPV) testing as part of cervical cancer screening for women over 30
• counseling on sexually transmitted infections
• counseling and screening for HIV
• lactation counseling and equipment to promote breast-feeding
• screening and counseling to detect and prevent interpersonal and domestic violence
• yearly well-woman preventive care visits to obtain recommended preventive services

You can view the Institute’s press release, recommendations, report brief, and full report, “Clinical Preventive Services for Women: Closing the Gap,” online. The Department of Health and Human Services will still need to adopt this list of recommendations for the care to be covered under the Affordable Care Act.

Some other coverage and discussion of this topic:

• NLIRH Applauds Panel’s Counsel to Cover Birth Control Under Health Reform – from the National Latina Institute for Reproductive Health
• Anti-Choicers Gear Up To Fight Guidelines on Preventive Care for Women – Jodi Jacobson at RHRealityCheck discusses the inevitable anti-choice backlash
• A Preventive Health Care Game-Changer for Women – at the Ms. Blog
• Statement from the March of Dimes commending the recommednations
• Doctors to HHS: Adopt Contraception Recommendations, Improve Women’s Health, Save Money – Press release from Physicians for Reproductive Choice and Health<
• Women’s Preventive Health Coverage Information Central – lots of news and resources on this topic from Raising Women’s Voices
• Women Should Get Free Birth Control, HHS-Backed Group Urges – at The Rundown, a PBS NewsHour blog

Seen other good links on this news? Leave ‘em in the comments!

On July 21, the National Women’s Law Center is hosting a “Birth Control: We’ve Got You Covered” blog carnival to talk about the importance of access to birth control and to encourage the U.S. government to include birth control in a list of services that will be available without a co-pay.

The Affordable Care Act requires coverage – without a co-pay – for preventive services. Decisions about which services will be included are expected sometime this summer. Advocates, including the NWLC, have been working to encourage the Institute of Medicine and Department of Health and Human Services to include birth control as one of the preventive services to be covered.

If you’re unfamiliar with the “blog carnival” concept, it’s when lots of people post on the same topic or theme, and links to the posts are usually collected somewhere online – in this case by the NWLC. If you plan to participate with your own blog post on why birth control should be included as a key preventive care services for women, sign up online.

Project Prevention, a program formerly known as C.R.A.C.K. that seeks to bribe/coerce women with drug addictions into be sterilized or accepting long-term birth control (that may not be medically appropriate) through financial incentives, started out in the United States by advertising quick cash for addicted women who surrendered their reproductive options and control. The program often targeted communities of color.

Needless to say, the program is vile and racist — founder Barbara Harris has been widely quoted comparing women to dogs and their children to unwanted animals, saying, “We don’t allow dogs to breed. We spay them. We neuter them. We try to keep them from having unwanted puppies, and yet these women are literally having litters of children.”

The program has been widely criticized in the United States. Lynn Paltrow and National Advocates for Pregnant Women have been outspoken in their concerns, noting:

NAPW’s examination of the program makes clear that, far from providing a useful response to problems associated with drug use and pregnancy, C.R.A.C.K. instead acts as a dangerous vector for medical misinformation and political propaganda that has significant implications for the rights of all Americans. Under the guise of openness, voluntary choice, and personal empowerment, C.R.A.C.K. not only promotes a vicious image of all drug users, it has won significant support for a program and an ideology that is at the core of civil rights violations and eugenic population control efforts.

The program had recently expanded to the United Kingdom, where it also has been criticized by organizations and bloggers.

Now Harris has apparently set her sights on South Africa, where she had plans to target women living with HIV. Project Prevention has apparently already set up in Kenya.

The Open Society Blog has some coverage of these developments, noting that “Project Prevention seems to have no knowledge of antiretroviral medications (ARVs) or PMTCT [preventing mother-to-child transmission], since they claim that getting HIV-positive women on long term birth control is ‘the only way’ to ensure there are fewer babies born with HIV.”

The head of the National Health Department in South Africa has reportedly said that the group will not be allowed to operate in the country, stating:

It’s a no, no, no! We have a Constitution in this country that causes us to respect human rights — including the right to choice. So there is no way that we are going to accept or to allow anyone coming from anywhere in the world to come in and force sterilization on any women in this country — because that will be against the Constitution. So it’s not acceptable and it’s a big ‘no’.

If only we so strongly prohibited these actions in this country.

Escrito por Christine; traducido por Ema Rosero del orginial en inglés Jan 19, 2011.

La mayoría de adolescentes y adultos sexualmente activos en los Estados Unidos utilizan métodos anticonceptivos y favorecen que la mujer haga por sí misma decisiones sobre su salud reproductiva. A pesar de este apoyo, los que se oponen a la planificación familiar y a los derechos de las mujeres han intentando presentarse como la verdadera voz de moralidad y han logrado avances políticos que amenazan la salud de la mujer.

Este año se celebró el 38vo aniversario de Roe vs. Wade el día 22 de enero. El grupo “Defensores para la salud de la mujer y la Campaña Cinta de Plata para que la mujer asuma sus derechos de reproducción y de justicia” (Silver Ribbon Campaign to Trust Women for Reproductive Rights and Justice) ha demostrado nuestra fortaleza y se ha reivindicado con respecto a los derechos que tiene la mujer para obtener servicios de salud.

La Campaña Cinta de Plata es el esfuerzo de docenas de organizaciones incluyendo Nuestros Cuerpos Nuestras Vidas, para darle prioridad a la ciencia sobre la ideología, ofrecerle a la mujer el apoyo debido sobre métodos para salud reproductiva, el acceso gratuito a anticonceptivos y el acceso al aborto legal.

Usted puede participar compartiendo la información a través de Twitter y el Facebook y llevando la cinta de plata “Confíe en la Mujer” a partir del 22 de enero hasta el 22 de febrero. Haga su propia cinta o puede hacer una donación a las organizaciones participantes para recibir una cinta.

Puede ir a la página de internet: OurSilverRibbon.org, para compartir su historia y mantenerse al día sobre los puntos de acción sometidas por organizaciones colaboradoras incluyendo un esfuerzo por agencias afiliadas a Planned Parenthood de California que ofrece la pastilla anticonceptiva disponible sin costo.  El grupo Physicians for Reproductive Choice and Health (Médicos a favor de la elección reproductiva y de salud) están presentando la Declaración de Derechos del Proveedor de Abortos (Abortion Provider’s Declaration of Rights), que usted puede firmar si desea apoyar a los miles de profesionales de salud que realizan abortos.

Ellen Shaffer, codirectora del Centro de Análisis de Políticas (Center for Policy Analysis) y la Dra. Sophia Yen, pediatra y especialista en medicina de adolescentes escribió un artículo para el Huffington Post en el que establece la manera como se ha politizado el derecho a la salud reproductiva y las formas diferentes en que la actual administración y los oponentes al aborto han restringido su acceso.

La mayoría de los adultos utilizan o han utilizado métodos anticonceptivos. Sin embargo, hasta el mejor método falla una vez en cien. La mitad de los embarazos no son planificados. Por lo menos una tercera parte de mujeres estadounidenses han tenido un aborto en sus vidas. La mayoría creen que los seguros médicos deberían cubrir abortos como bajo servicios de salud reproductiva. Ochenta y seis por ciento de aseguradores proveídos por empleadores cubren el aborto. En estos tiempos de dificultad económico es crucial que las familias tengan la opción de traer o no a un niño(a) al mundo.

Sin embargo, el aborto ha sido estigmatizado por un movimiento minoritario bien organizado y bien financiado, incluyendo grupos extremistas que promueven actos violentos. Nuestra salud reproductiva entonces se utiliza como una cuña, y la oposición se aprovecha de la ansiedad entre votantes causada por la economía y otros asuntos sociales para reclamar el apoyo a su ideología regresiva, anti-mujer y anti-auto determinación.

Vimos un presidente a favor del aborto quien firmó leyes restringiendo acceso al aborto en al menos tres maneras: en la ley de  reforma de salud, con una orden ejecutiva, y con un reglamento sobre los planes de salud del estado. A pesar del hecho de que la contracepción cabe bajo el área de salud preventivo la Administración se sintió obligada a convocar un grupo especial para determinar si los anticonceptivos podían hacerse disponibles bajo métodos de salud preventivo.

En la actualidad 87% de los condados carecen de proveedores de aborto. La carga recae duramente sobre los más vulnerables.

En su conclusión, indican que que estamos en mayoría los que confiamos en la mujer para elegir la mejor alternativa anticonceptiva para ella y que nos toca exigir nuestros derechos al respecto.

“Confíen en las mujeres” fue el lema adoptado por el Dr. George Tiller, proveedor de abortos quien fue  asesinado por el activista en contra del aborto Scott Roeder, el 31 de mayo de  2009. El serio compromiso de Tiller sobre la capacidad de la mujer tomar sus propias decisiones de salud reproductiva al consultar con su médico y familiares es un legado poderoso y duradero. Unirse a la campaña Cinta de Plata es un paso hacia adelante para garantizar que no demos pasos hacia atrás.

The majority of sexually active adolescents and adults in the United States use birth control and are in favor of women being able to make their own reproductive health decisions. Despite this support, opponents of family planning and women’s rights have tried to assert themselves as the true moral voice — and have made political gains that severely threaten women’s health.

This year, as women’s health advocates celebrate the 38th anniversary of Roe v. Wade on Jan. 22, the Silver Ribbon Campaign to Trust Women for Reproductive Rights and Justice has emerged as an opportunity to show our strength and claim our rights to the legal healthcare to which we are entitled.

The Silver Ribbon Campaign is the effort of dozens of organizations — including Our Bodies Ourselves — committed to prioritizing science over ideology and offering full support for reproductive healthcare; free access to birth control; and keeping abortion legal and accessible.

You can take part by spreading the word through Twitter and Facebook and by wearing a Trust Women Silver Ribbon from Jan. 22 – Feb. 22. Make your own or make a donation to one of the participating organizations to receive a ribbon.

At OurSilverRibbon.org, you can also share your story and stay up to date on action items submitted by partner organizations, including an effort by Planned Parenthood Affiliates of California to make prescription birth control available without a co-pay. Physicians for Reproductive Choice and Health is featuring an Abortion Provider’s Declaration of Rights that you can sign to show your support for the thousands of medical professionals who perform abortions.

Ellen Shaffer, co-director of the Center for Policy Analysis, and Dr. Sophia Yen, a pediatrician and adolescent medicine specialist, wrote a piece this week at the Huffington Post that lays out how politicized the right to reproductive healthcare has become and the various ways in which both the current administration and abortion opponents have restricted access.

Most adults use or have used birth control. However, even the best birth control fails one time in a hundred. Half of all pregnancies are unplanned. At least a third of U.S. women have an abortion during their lives. Most adults believe that abortion care, a legal procedure. should be covered by health insurance as part of reproductive health services. 86% of employer-based health plans currently cover abortion. In these hard economic times, it is crucial that families have the choice whether to bring a child into the world.

But abortion has been stigmatized by a well-organized, well-funded minority movement, including extremists who provoke violent acts. Our reproductive health is used as a wedge issue, seizing on voters’ anxieties about the economy and social issues to claim support for the regressive, anti-woman, anti-self-determination ideology of the right.

We saw a pro-choice president sign laws restricting access to abortion in at least three different ways: In the health care reform law, an executive order, and a regulation on state health plans. Despite the obvious fact that contraception is prevention, the Administration felt compelled to convene a panel to determine if contraceptives count as preventive care.

87% of counties now have no abortion providers. The burden falls hardest on the most vulnerable.

In their conclusion, they note that those of us who trust women are the majority, and it’s up to us to demand our rights.

“Trust women” was a motto adopted by Dr. George Tiller, an abortion provider who was murdered on May 31, 2009 by anti-abortion activist Scott Roeder. Tiller’s strong commitment to the ability of women to make their own decisions in consult with their doctors and families is a powerful and lasting legacy. Joining the Silver Ribbon is one step toward ensuring we don’t take any more steps back.

Earlier this year, we wrote about the Center for Reproductive Rights’s efforts to bring attention to young women’s continued lack of over-the-counter access to emergency contraception, despite a lack of evidence for the current age-based cutoff.

In March of 2009, a judge ordered the FDA to extend over-the-counter access to 17-year-olds, and also to reconsider these age restrictions in general. Last week, the Center filed a motion for civil contempt against the FDA arguing that the agency has failed to reconsider the age restrictions for women younger than 17.

The Center has background materials and more information at http://reproductiverights.org/en/feature/the-center-takes-the-fda-back-to-court. The group is encouraging supporters to contact the FDA asking the agency to “respect the findings of its own scientific review panel and take immediate action to end restrictions on emergency contraception.”

[In other we're-still-waiting news, almost two years after the administration announced that they were going to review the controversial "conscience clause," we still haven't seen any action. As far as I know, the proposed public comment period never happened.]

A new study in the journal Contraception reveals the power of a simple conversation: When trained counselors at family planning clinics ask young women if they have experienced reproductive coercion, it reduces the odds of their male partners forcing them to become pregnant.

Reproductive coercion refers to abusive male behaviors to promote pregnancy, including “birth control sabotage” (interference with contraception) and/or “pregnancy coercion,” such as threatening to harm a woman if she uses birth control or if she has an abortion, and threating to leave her if she doesn’t get pregnant.

The Family Violence Prevention Fund responded enthusiastically to the results of the study:

A brief intervention was associated with a 70 percent reduction in the odds of male partner pregnancy coercion among women who recently had experienced intimate partner violence. Study participants who were asked about reproductive coercion and then counseled about harm-reduction strategies — including switching to longer-acting contraceptives and contacting domestic and sexual-assault resources — were also 60 percent more likely to report ending a relationship because it felt unsafe or unhealthy.

“There is a strong, indisputable link between domestic and dating violence and unintended pregnancy. This study is extremely important because it identifies an effective solution that can be implemented relatively easily,” said Family Violence Prevention Fund President and Founder Esta Soler. “We need to build on these results by making this intervention the norm in health care settings throughout the nation as quickly as possible.”

The study was funded by the National Institute of Child Health and Human Development; the intervention was designed by reproductive health experts, UC Davis School of Medicine, the Harvard School of Public Health, and the FVPF.

An earlier study this year, also published in Contraception, concluded that 20 percent of women experienced pregnancy coercion and 15 percent experienced birth control sabotage.

The FVPF is calling for immediate action based on this latest evidence: “This study is extremely important because it identifies an effective solution that can be implemented relatively easily,” said Soler. “We need to build on these results by making this intervention the norm in health care settings throughout the nation as quickly as possible.”

Go to FVPF’s Know More Say More website for more information and opportunities for action. The site includes resources for healthcare providers, including suggestions on how to assess for reproductive coercion [PDF], including sample scripts, and how to integrate assessments into clinical practice [PDF].

In June, we wrote about the FDA’s Advisory Committee for Reproductive Health Drugs recommendation to approve ulipristal acetate (brand name “ella”) for emergency contraception. On Friday, the FDA did approve the drug, as a prescription-only emergency contraceptive to be taken up to 120 hours (5 days) after contraceptive failure/unprotected sex. Existing “Plan B”-type emergency contraception is currently approved for use up to 72 hours.

Despite the five-day use window for this drug (and the three-day window for others), some media outlets persist in calling it a “morning-after” pill. Ahem.

At the time of our June post, a transcript of the Advisory Committee meeting – which includes the text of presentations and detailed discussion of the drug – was not yet available. That transcript is now online [PDF], including comments from representatives of Planned Parenthood and the National Women’s Health Network.

See our previous post for further discussion of the new emergency contraceptive.

Via @NLIRH, we learned that the National Latina Institute for Reproductive Health, California Latinas for Reproductive Justice and the Colorado Organization for Latina Opportunity and Reproductive Rights have teamed up for the first annual Latina Week of Action for Reproductive Justice, starting today and running until August 15th.

As part of the week, the groups are asking supporters to contact their Congressional representatives “to ask the Department of Health and Human Services (HHS) to support comprehensive family planning services that include contraception as a key women’s health service under the Women’s Health Amendment.” As with many online action campaigns, you can put in your zip code to identify your Representative and Senators and send them a letter explaining that “Latinas, immigrants, and women of color will be disproportionately affected if contraception is not made affordable and accessible.”

There is also an online conversation about Latinas and contraception happening all week, with an inaugural blog post, My-So-Called-Sex-Education, up at Nuestra Vida, Nuestra Voz (NLIRH’s blog) on the need for information about and access to contraception. Further discussion will happen on Facebook, via Twitter (#latinaRJwk), and on partnering blogs such as VivirLatino. There are in-person events taking place in a few cities; check out this page for details.

Two aspects of recent health reform legislation may help expand access to affordable contraception and family planning services. The first of these is a provision that allows states – through their Medicaid programs – to receive federal funding to cover family planning and related services and supplies for individuals not otherwise eligible for Medicaid.

This coverage would be available to individuals (women and men) who are not currently pregnant and whose income does not exceed an income eligibility level established by the state (similar to special eligibility rules for pregnant women who wouldn’t otherwise quality for Medicaid). Family planning-related services that may be covered include STI diagnosis and treatment, treatment of urinary tract infections, treatment of major complications from family planning procedures such as IUD insertion, and vaccines and other preventive services when provided as part of routine family planning visits.

States will basically have to opt in to this coverage by submitting some paperwork to the Centers for Medicare & Medicaid Services (CMS), the federal agency that oversees Medicaid. States will also set the eligibility guidelines for coverage up to a certain threshold. It is not yet clear how many or which states will be offering this coverage, which will expand access to family planning services for people who earn to much to qualify for Medicaid but who are having difficulty affording this care.

Another provision of the health care reform legislation that will take effect in late September, often referred to as the “Mikulski amendment,” requires that health plans cover preventive care and screenings (at no cost to the individual) for women. The coverage must be based on current evidence-based recommendations of the United States Preventive Services Task Force, and must includevaccines recommended by the CDC, and other care and services “as provided for in comprehensive guidelines supported by the Health Resources and Services Administration [HRSA]for purposes of this paragraph.”

What’s not clear is what guidelines the HRSA will support. Some have suggested that because HRSA doesn’t seem to have its own set of guidelines now, these will need to be created. I think another possible interpretation is that HRSA will identify an existing set of guidelines to support (such as from ACOG or another professional or governmental health organization). Whether new standards have to be created or HRSA simply designates some existing guidelines to support will determine how much room there is to advocate for services, but what will happen is not entirely clear at the moment.

A recent Guttmacher policy review has more on this issue, specifically on whether contraception might be included as preventive care. Guttmacher’s Adam Sonfield has also written about the issue for CNN, concluding:

In short, the case for ensuring family planning services are comprehensively integrated into women’s preventive care and insurance coverage is compelling. More and better contraceptive use will lead to more pregnancies that are planned and wanted, which will lead to more women who are healthy during their pregnancies and whose babies are born healthy. Who could argue with that?

The National Latina Institute for Reproductive Health is planning a “virtual cafecito” to discuss the issue of whether family planning will be included as a preventive service and to discuss strategies for ensuring that Latinas and other women have access birth control options as a preventive service. The call-in discussion will occur Wednesday, July 4 at 1pm EST; register online to participate.