Sunday, October 31, 2010

Contraception could be free under health care law.

From the Associated Press comes this story this evening:

Fifty years after the pill, another birth control revolution may be on the horizon: free contraception for women in the U.S., thanks to the new health care law.

The use of birth control is "virtually universal" in the U.S., according to a government report this summer from the National Center for Health Statistics. Nearly 93 million prescriptions for contraceptives were dispensed in 2009, according to IMS Health, a market analysis firm. Generic versions of the pill are available at Walmart stores, for example, for $9 a month.

Still, about half of all pregnancies are unplanned, and many occur among women using some form of contraception. The government says the problem is rarely the birth control method, but "inconsistent or incorrect use," such as forgetting to take a pill.

Advocates say free birth control would begin to address the problem.

"We can look at other countries where birth control is available for no cost, and what we see are lower pregnancy rates, lower abortion rates and lower teen pregnancy," said Cecile Richards, president of Planned Parenthood.

It would remove a cost barrier that may be keeping women away from more reliable long-acting birth control, and also affects those who don't do well on inexpensive generics.

A major research study now taking place in St. Louis provides a glimpse of how things might change.

The Contraceptive CHOICE Project is providing free birth control to as many as 10,000 women, tracking their decisions and the results. About 70 percent have chosen long-acting contraceptives such as IUDs (intrauterine devices) or implants, which are reversible and have a much lower failure rate than pills or condoms. The proportion of U.S. women using such methods remains low; part of the reason seems to be higher upfront cost.

"The shift we need to see in the United States is a shift away from methods like the pill and condoms to the most effective methods, like implants and IUDs," said Dr. Jeffrey Peipert, a principal investigator on the study. "And we'll only see that shift if somebody is willing to pay for it."

How the Obama administration will apply the law remains to be seen. It could allow insurance plans wide discretion on meeting the coverage requirement. A panel convened by the Institute of Medicine will hold its first meeting Nov. 16 to begin work on recommendations to HHS. The department has until next August to make its decision.

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