New ObamaCare mandate: no co-pays on contraceptives


posted at 12:45 pm on August 2, 2011 by Ed Morrissey
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The ObamaCare bill has resulted in an explosion of ambiguity and arbitrary rulings, mainly focused at first on temporary waivers for some insurers and employers on requirements for meeting the threshold of payouts to premiums.  The Department of Health and Human Services stopped issuing waivers under pressure from Congress to explain their methodology, but a new ruling by Kathleen Sebelius will likely prompt even more protests.  The Obama administration ordered insurers to cover prescription contraceptives and a range of other “women’s wellness” services and products without co-pays:

    Health insurance plans must cover birth control as preventive care for women, with no copays, the Obama administration said Monday in a decision with far-reaching implications for health care as well as social mores.

    The requirement is part of a broad expansion of coverage for women’s preventive care under President Barack Obama’s health care law. Also to be covered without copays are breast pumps for nursing mothers, an annual “well-woman” physical, screening for the virus that causes cervical cancer and for diabetes during pregnancy, counseling on domestic violence, and other services.

    “These historic guidelines are based on science and existing (medical) literature and will help ensure women get the preventive health benefits they need,” said Health and Human Services Secretary Kathleen Sebelius.

    The new requirements will take effect Jan. 1, 2013, in most cases. Tens of millions of women are expected to gain coverage initially, and that number is likely to grow with time. At first, some plans may be exempt due to a complex provision of the health care law known as the “grandfather” clause. But those even plans could face pressure from their members to include the new benefit.

Let’s put this in its proper context.  Thanks to this new mandate, insurers will eat hundreds of millions or perhaps billions of dollars in additional costs each year.  Guess how they will recoup those costs?  Premiums will rise across the board, meaning that everyone will pay the additional cost as well as the specific patients getting the services and products.

Does this solve some sort of pressing gap in society?  Not really.  As the Huffington Post report notes, contraceptive use is already nearly universal.  The report quotes a government study that shows 90 million prescriptions for contraceptives are dispensed annually.  Clearly, there is no big gap in access due to having co-pays for the Pill.  If poor women had problems paying the additional cost, then HHS could have ordered Medicaid to end co-pays, a power that was already within their jurisdiction before ObamaCare’s passage.

So where does this end?  Do we next mandate an end to co-pays on Lipitor because cholesterol is a problem in American health?  I can tell you that the co-pays on that medication are higher than on most and probably represent more of a barrier to access than co-pays on the Pill, let alone access to breast pumps and counseling on domestic violence.

This is a preview of life under ObamaCare.  This edict got handed down from the mountain purely for political purposes.  The Obama administration wants to bolster its standing with women ahead of the next election; this mandate will probably get featured in an endless series of campaign ads.  “President Obama protects women!” the copy will read.  In the meantime, rational provider-patient cost sharing on non-critical products and services will be discarded, forcing the rest of us to eat the cost in higher premiums.  It’s the ultimate in arbitrary exercises in authority.

And people wonder why employers, who have to price the costs of adding positions, aren’t hiring any more.

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