HHS urged not to cover contraception or sterilization in health plans

The Department of Health and Human Services (HHS) should not require coverage of contraception or sterilization in group and individual health plans as part of "preventive" services for women, said representatives of the United States Conference of Catholic Bishops (USCCB) as HHS continued its deliberations on a final list of required preventive services under the Patient Protection and Affordable Care Act (PPACA).

"These drugs, devices and procedures prevent not a disease condition, but the healthy condition known as fertility," said Anthony Picarello, USCCB general counsel, and Michael Moses, associate general counsel, in a September 17 letter to HHS. They added that contraception and sterilization "pose significant risks of their own to women's life and health; and a federal program to mandate their inclusion would pose an unprecedented threat to rights of conscience."

Picarello and Moses argued that contraception cannot be considered "preventive" on the grounds of preventing abortion because "abortion is not itself a disease condition, but a separate procedure that is performed only by agreement between a woman and a health professional," and "studies have shown that the percentage of unintended pregnancies that are ended by abortion is higher if the pregnancy occurred during use of a contraceptive."

They noted that at least one drug already approved by the Food and Drug Administration (FDA) for "emergency contraception" can actually cause early abortions, so a mandate of prescription contraception coverage as a preventive service would "be in direct tension with [PPACA's] statutory prohibition on mandating any abortion service."

They also noted that such a mandate would threaten "rights of conscience for religious employers and others who have moral or religious objections to these procedures. In this regard, the Administration's promise that Americans who like their current coverage will be able to keep it under health care reform would be a hollow pledge."

They added that this "would also contradict longstanding federal precedents on respect for conscientious objection to such procedures and such coverage," including the Church amendment, which since 1973 has protected conscientious objection to abortion and sterilization.