Mandating Coverage of Contraceptives Is Bad Social Policy

Chuck Donovan /

The Institute of Medicine (IOM), the health policy arm of the National Academy of Sciences, has issued its long-awaited report making recommendations to the U.S. Department of Health and Human Services (HHS) on mandatory insurance coverage of preventive services for women’s health care.

The mandatory coverage of certain preventive services was required by an amendment to the Patient Protection and Affordable Care Act (PPACA), known colloquially as Obamacare. The central feature of PPACA is a mandate that every American purchase a health insurance policy. The IOM report is thus rightly seen as envisioning a mandate within a mandate.

The IOM recommendations on preventive medicine not only would include a “full range” of contraceptives but would also stipulate that the contraceptives be offered without co-pays and exempt from deductibles—preferential treatment not accorded other procedures or prescription drugs. The term contraceptive is impressively flexible, including sterilization and devices and drugs that are known to have a mode of action that includes causing an abortion early in pregnancy. Among the latter is a new drug called ulipristal, or Ella, which is characterized as a morning-after pill, but it can actually work days after conception by “preventing attachment to the uterus,” as a promotional video from the manufacturer describes it.

If HHS follows the IOM’s recommendations, the burdens of the new mandate on individual and institutional conscience, in addition to the assault on sound health care policy, will be immense. Consider just the following impositions:

HHS Secretary Kathleen Sebelius has stated that she welcomes the IOM report, which she requested under the law, and that her department will issue its formal “preventive services” list soon. Both sexual activity and use of contraceptives are voluntary behaviors in areas where sensitivity to individual conscience is especially warranted. HHS should not compound the policy errors present in Obamacare by trampling on conscience in the name of medicine.