Last week’s report from the Institute of Medicine on what Clinical Preventive Services for Women should be funded through the Patient Protection and Affordable Care Act (aka the new federal Health Care Program) generated headlines for its recommendation (among many others) that birth control be made available to all fertile females for free.

In the context of contemporary fertility battles, this is bound to lead to argument. Should a citizen who doesn’t approve of birth control be understood to be funding the birth control of those who choose to use it — and therefore have a basis for objecting? Or should we understand that the many tax payments from those who approve of birth control for those who want it are those that are funding it, while the taxes of those who don’t approve of birth control are funding the costs associated with birthing and raising unplanned kids?

The IOM, a nonpartisan medical review board, finds that birth control is one among several key preventive measures (along with screens for disease and domestic violence) that would markedly improve the health of women. A future in which women’s health matters? The fact that it’s proposed at all suggests that we’ve already made progress toward that future. Debate will follow. And women will doubtless have much to say, as well as increasingly powerful voices with which to say it.

Update: The Secretary of Health and Human Services Kathleen Sebelius has issued new guidelines adopting the IOM recommendations.

The guidelines call for no cost to patients for such services as:
Well-woman visits
Gestational diabetes screening
HPV DNA testing
STI counseling, and HIV screening and counseling
Contraception and contraceptive counseling (yes, that’s free birth control)
Breastfeeding support, supplies, and counseling
Domestic violence screening

“The Affordable Care Act – the health insurance reform legislation passed by Congress and signed into law by President Obama on March 23, 2010 – helps make prevention affordable and accessible for all Americans by requiring health plans to cover preventive services and by eliminating cost sharing. Preventive services that have strong scientific evidence of their health benefits must be covered and plans can no longer charge a patient a copayment, coinsurance or deductible for these services when they are delivered by a network provider.”

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