This week the Institute of Medicine (IOM)--a nongovernmental, nonpartisan arm of the National Academy of Sciences--issued a major report urging the federal government to count birth control as preventive care under the health reform law. If the Obama administration, which commissioned the report, takes the IOM's advice, insurance companies would be have to cover pregnancy prevention in full--without co-pays!
Although radical anti-choice folk, their mouthpieces, and even a few neutral media sources have branded this recommendation "free birth control," it's not. The women who plunk down about $5 to $50 a month for, say, the Pill are already paying their insurance premiums. This would just lighten their financial load.
Along with co-pay free coverage of the Pill, the morning-after pill, tube-tying and other FDA-approved contraceptive methods, the IOM report also recommends that insurance companies fully cover what the panel described in the report as:
- improved screening for cervical cancer, counseling for sexually transmitted infections, and counseling and screening for HIV;
- a fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes;
- services for pregnant women including screening for gestational diabetes and lactation counseling and equipment to help women who choose to breastfeed do so successfully;
- at least one well-woman preventive care visit annually for women to receive comprehensive services;
- and screening and counseling for all women and adolescent girls for interpersonal and domestic violence in a culturally sensitive and supportive manner.
Now, if you're an insurance company executive; you're a member of the Family Research Council; you roll with the United States Conference of Catholic Bishops; or you vote against your own interests because you've been Tea Partied into believing that enriching insurance companies is a patriotic act, this is bad news.
If you're a woman of color who doesn't fit the description above, this IOM report, "Clinical Preventive Services for Women: Closing the Gaps" is particularly good news for you. A few (lesser known) reasons why:
Gestational diabetes is a big problem for us
Between two and 10 percent of women develop diabetes due to pregnancy. According to the American College of Gynecology and Obstetrics (ACOG), risk factors include:
- being Native American, Asian, Hispanic, African American, or Pacific Islander;
- being overweight;
- having a close relative with diabetes.
And women with gestational diabetes are more likely to:
- develop preeclampsia (a condition that can cause seizures and liver and kidney problems for mom, and the premature birth of baby);
- have a very large baby (which could mean a more complicated--and painful--vaginal delivery or even an emergency C-section);
- and have Type 2 diabetes after pregnancy
The IOM recs would compel insurance companies to cover screening for women who are 24 to 28 weeks pregnant and at the first prenatal visit for women at high risk for diabetes.
We really need better HPV testing
HPV (human papilloma virus) awareness, vaccination and testing has increased among women of all races. But the disease HPV causes, cervical cancer, continues to affect women of color most. According to the most recent available stats from the CDC:
- Latinas have the highest cervical cancer rate in the country. -Black women have the second highest, followed by white, Native American and Asian/Pacific Islander women.
- Black women are most likely to die of cervical cancer, followed by Latinas, Native American and Asian/Pacific Islander sisters.
- Most cervical cancer cases occur in the South.
By placing HPV DNA testing--which tells women if they have a high-risk HPV strain that causes cervical cancer--on the same level as the traditional annual Pap smear, the IOM is sending a message that it's not a luxury item, but a necessity for women 30 and older, every three years.
The cost of a breast pump shouldn't be an obstacle to breast feeding
Remember all of that drama earlier this year when Michelle Obama promoted breast feeding as a way to tackle childhood obesity and gave a special shoutout to black women because 40 percent of our babies aren't breastfed at all? How Michele Bachmann ignorantly cast Obama's advocacy as a sinister effort to establish a nanny state? ("To think that government has to go out and buy my breast pump for my babies, I mean, you wanna talk about the nanny state -- I think you just got the new definition of the nanny state.")
Well, the IOM offers a common-sense way to address the fine senator's concern: Along with lactation counseling, the cost of renting a pump would be fully covered by insurance companies. At about $35 for a manual pump and up to $275 for an electric one that most working mothers would need, this could make a real difference for working poor women and women of color.
OK, so what's next?
The Health and Human Services Department will reportedly decide on which of the IOM recommendations to adopt by August 1. Anti-choicers have already objected because they consider FDA-approved emergency contraception pills to be a form of abortion. And health reform bashers will likely push back on fiscal grounds since the IOM didn't do a cost-benefit analysis. In short, we need to get busy telling everyone who will listen to do the right thing and not bend over for really loud, cynical minority.
And for a detailed debunking of anti-choice claims, read this.