The AAFP and five other physician organizations are warning that two new interim final rules on coverage of women's preventive health care could dramatically increase costs for patients and cause harm to public health.
The rules, issued Oct. 6, create a broad exemption for employers to restrict coverage of women's preventive health services on moral or religious grounds and could force many women to pay out-of-pocket costs for essential health services. Employers are now required under the Patient Protection and Affordable Care Act (ACA) to provide insurance coverage with no cost-sharing for women's preventive health, including breast and cervical cancer screening, breastfeeding services, contraception and contraceptive counseling.
In an Oct. 6 letter to President Donald Trump, the organizations urged the president to withdraw the rules, noting that they threaten the gains in access to essential health services that have been made in recent years. In blunt language, the letter states, "No woman should lose the coverage she has today."
The two rules, titled "Religious Exemptions and Accommodations for Coverage of Certain Preventive Services under the Affordable Care Act"(www.federalregister.gov) and "Moral Exemptions and Accommodations for Coverage of Certain Preventive Services Under the Affordable Care Act,"(www.federalregister.gov) took effect Oct. 6 and are scheduled to be published Oct. 13.
"These rules would create a new standard whereby employers can deny their employees coverage based on their own moral objections," the letter stated. "This interferes in the personal health care decisions of our patients, and inappropriately inserts a patient's employer into the physician-patient relationship."
Under the ACA, 62 million women gained access to valuable preventive health care. Before the law was implemented, women spent 30 percent to 44 percent of their total out-of-pocket health costs on birth control. After the law took effect, women saved about $1.4 billion on out-of-pocket costs for contraception in one year.
"No-copay coverage of contraception has improved the health of women and families and contributed to a dramatic decline in the unplanned pregnancy rate in the United States, including among teens, now at a 30-year low," the letter stated.
Unplanned pregnancy often results in a woman delaying prenatal care and is tied to poor health outcomes for children, including low birth weight and a higher rate of birth defects.
"Contraception is an integral part of preventive care and a medical necessity for women during approximately 30 years of their lives," the letter stated. "Access to no-copay contraception leads to healthier women and families. Any move to decrease access to these vital services would have damaging effects on public health."
The letter, which was also sent to HHS, the attorney general's office, the Department of Labor and Department of the Treasury, was signed by the AAFP, the American Academy of Pediatrics, the American College of Physicians, the American Congress of Obstetricians and Gynecologists, the American Osteopathic Association, and the American Psychiatric Association.
These organizations have been meeting with legislators in recent weeks to urge them to not roll back advances as they work on improving the nation's health care law.
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