American women ought to be able to get their birth control for free, according to a new report from the Institute of Medicine (IOM).  The group is the latest to weigh in on which preventive services health insurers should have to offer at no cost under the new health law.

Photo by Ceridwen

Officials at the Department of Health and Human Services asked the IOM, an independent and well-respected research organization, to advise what services should be considered essential. The birth control decision has proven particularly controversial, with anti-abortion groups arguing that contraception is against the religious beliefs of some Americans, and that some forms of emergency contraception, including Plan B, are akin to early abortion.

The IOM report recommends that health insurers skip the co-pay for all contraceptives approved by the Food and Drug Administration. For birth control pills, that can cost about $25 each month.  Condoms also are included on the FDA list of contraceptives and could be provided at no cost to patients.  According to the press release from the IOM, “[w]omen with unintended pregnancies are more likely to receive delayed or no prenatal care and to smoke, consume alcohol, be depressed, and experience domestic violence during pregnancy. Unintended pregnancy also increases the risk of babies being born preterm or at a low birth weight, both of which raise their chances of health and developmental problems.”

The IOM also recommended that women older than 30 be eligible to receive free HPV tests along with their annual Pap smears to detect cervical cancer. Screening for HPV, the virus that causes cervical and other cancers, the IOM report maintains, can increase the chances of identifying women at risk and providing early treatment.

Other preventive services recommended in the report include:

•             screening for gestational diabetes

•             counseling on sexually transmitted infections

•             counseling and screening for HIV

•             lactation counseling and equipment to promote breast-feeding

•             screening and counseling to detect and prevent interpersonal and domestic violence

•             yearly well-woman preventive care visits to obtain recommended preventive services

The final decision on what services will be considered “preventive” will be made by HHS. Insurers who participate in the exchanges set up under the health law will have to follow this determination.