The AAFP today made yet another strong appeal to CMS to guarantee private health insurance coverage of women's preventive health services -- including contraception -- with no out-of-pocket costs.
Such coverage was mandated by the Patient Protection and Affordable Care Act (ACA).
In a letter to CMS Administrator Seema Verma, M.P.H.,(2 page PDF) dated Nov. 30, the AAFP offered a response to two interim final rules published in the Oct. 13 Federal Register that are, the AAFP said, "designed to expand exemptions to protect religious or moral beliefs" for some entities and individuals who offer health insurance plans that are subject to mandated contraceptive coverage.
The letter, signed by AAFP Board Chair John Meigs, M.D., of Centreville, Ala., spelled out the two regulations in question: "Religious Exemptions and Accommodations(www.gpo.gov) for Coverage of Certain Preventives Services Under the ACA" and "Moral Exemptions and Accommodations(www.gpo.gov) for Coverage of Certain Preventive Services Under the ACA."
The AAFP called on CMS to "immediately withdraw these two interim final rules so that women do not lose coverage."
The Academy pointed out that because of coverage provided by the ACA, more than 62 million women with private insurance "now have access to these vital health care services, including breast and cervical cancer screening, breastfeeding services and supplies, contraception and contraceptive counseling."
Coverage guidelines were based on reliable clinical and scientific evidence, the AAFP pointed out.
"Maintaining access to this existing coverage is critical to ensuring American women and families can access the care that they need," argued the AAFP.
The letter ticked off some of the unintended consequences of decreasing access to vital health services for women. For instance, unplanned pregnancies often delay prenatal care, which can result in
- increased risk of birth defects,
- low-birth-weight newborns, and
- poor mental and physical function in early childhood.
And there's a huge financial impact related to unplanned pregnancies that, according to 2015 research from the Guttmacher Institute,(www.guttmacher.org) resulted in $21 billion in government expenditures in just one year alone.
The AAFP told CMS that when women have access to contraception, they are healthier and more likely to achieve their full potential -- thereby contributing to the nation's economic success.
Lastly, and of particular concern to the AAFP, is that the rules "would create a new standard" allowing employers to deny coverage based on their own moral objections, which "interferes in the personal health care decisions of our patients and inappropriately inserts a patient's employer into the physician-patient relationship."
Furthermore, the rules could "open the door to moral exemptions" for other essential preventive services such as immunizations, said the AAFP.
The AAFP noted that its comments were consistent with existing Academy policy on family planning and summed up its stand on the regulations in question by telling CMS to "immediately withdraw these harmful rules and instead focus on rules that improve access to care."
Related AAFP News Coverage
Fresh Perspectives blog: In Defense of Reproductive Health Care