The American College of Obstetricians and Gynecologists has proposed a new idea. They say oral contraceptives should be made available over-the-counter without the need for a prescription. How would this affect your health insurance coverage?
In August of 2011, the Affordable Care Act was expanded to include the coverage of women’s preventative health services. This means that all health insurance plans must cover the cost of those services, including all FDA approved forms of contraception, without charging a co-pay or deductible.
All health plans, whether they are individual or an employer sponsored health plan, must cover birth control in this way. This law took effect as of August of 2012. Health plans purchased before that date will have to include birth control coverage when the plan renews.
Recently, the American College of Obstetricians and Gynecologists (ACOG) have stated that oral contraceptives should be made available without a prescription. In other words, they believe that “the pill” should be reclassified as an over-the-counter medication. Other over-the-counter medications include aspirin, some antihistamines, cough and cold medications, and some pain relief medications.
Why does the ACOG want oral contraceptives to be easier for women to access? One reason is because the rate of unintended pregnancies in the United States hasn’t changed in the past 20 years. The rate is viewed by ACOG as “unacceptably high”. This can be reduced if women (especially young women) had easier access to birth control.
Another reason is that ACOG feels that women are capable of self-screening for conditions or other factors that would make it unsafe to take the pill. For example, a woman knows whether or not she is a smoker, and she knows if she is over the age of 35. A third reason is that “the pill” has been around for long enough to there be evidence that it is a safe medication. (Childbirth has more risks involved with it than oral contraception does).
If the Food and Drug Administration chose to follow the advice of ACOG, and made oral contraceptives something a woman could walk into a pharmacy and purchase without a prescription, how would that affect your health insurance? First of all, it wouldn’t change the law that says that health insurance plans must cover all FDA approved forms of contraception.
That being said, some things are unclear. Part of the reason why health insurance must cover oral contraceptives is because it is a prescription medication. Remove the need for a prescription, and it might allow a health insurer to be allowed to refuse coverage for it.
Right now, insurance plans do not cover the cost of any over-the-counter medication. On the other hand, it is possible that the health reform laws would still require insurers to cover birth control, whether or not it requires a prescription.
At this time, it would be safe to say that your insurance company will have to cover the cost of “the pill” up through the time that the FDA chooses to make it an over-the-counter medication. (The FDA may, or may not, choose to do that).
Image by Sarah C on Flickr