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The 2010 health care reform has been the center of debates since it was passed this past March. One key aspect of the new legislation was the mandate that new health insurance plans must offer free preventative health care to patients in an effort to improve the overall health of the country.

However, including one service in the preventative care has been a source of contention for many groups. Namely, that service is free contraception and family planning services for women.

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Should Birth Control Be Included Under the Preventative Care Mandate?

According to Michelle Andrews from Kaiser Health News, American women spend an average of 30 years attempting to prevent pregnancy, and only five years of their lives actively trying to become pregnant. Birth control is one important approach to family planning, and many women’s and employer groups argue that it should be deemed a preventative service.

Still, many more conservative groups oppose including contraceptives in the preventative care mandate, honing in on the support of socially conservative voices. The U.S. Conference of Catholic Bishops argues that pregnancy is not the same as a disease, and therefore contraception should not be placed in the same category as preventative care.

Already, 27 states include birth control as preventative care measures. According to Ms. Andrews, there are over 3 million unplanned pregnancies nationwide every year—a product of the high cost of birth control. Women who use the birth control pill as a contraceptive can expect to spend nearly $75 every month to prevent pregnancy. Not surprisingly, many unexpected births can be attributed to the high cost of birth control options like the pill and IUDs (intrauterine devices).  Even when health insurance plans provide birth control, copayments could still be too high for women—ranging from $50 for the birth control pill and hundreds for IUDS. Young women in particular are hit hard by the prices.

And remember—even married women use birth control to prevent unwanted pregnancy. In fact, over 11 million American women use contraceptives.  Unplanned pregnancies actually cost the American health care system over 5 billion dollars every year—and 40% of these births are covered by Medicaid. Low-income women on Medicaid are less likely to have access to affordable birth control. Plus, many health plans for individuals do not include maternity coverage.

Some employer groups argue that offering contraceptives as a part of preventative care will decrease the cost of insurance, as prenatal and postnatal care is far more expensive than the cost of birth control.

Still, the issue is a touchy one—pregnancies are not as black and white as diseases.  To the millions of American on birth control, hoping to avoid pregnancy, birth control is a crucial part of preventative care. To other Americans, pregnancy is not a disease to be prevented, but the gift of a life. Thus, birth control—like the new morning after pill, Ella One— falls into the health care reform’s gray area of morality.

Despite the tremendous cost benefits that providing contraception would provides—as well as a high demand, the White House took the politically safe route and opted not to include contraception in the preventative care mandate.

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