On Wednesday, July 20, the Institute of Medicine (IOM) will make public its recommendation for what should be included in the “preventive care for women” mandate under the Patient Protection and Affordable Care Act (PPACA), the health care reform law passed by Congress in 2010. It seems likely the IOM announcement will spell doom for rights of conscience.
PPACA requires all private health insurance plans to provide coverage of “preventive care for women,” not just those plans participating in the insurance exchanges that the law requires be established by 2014. These services must be covered without cost-sharing, meaning these services must be fully covered without a co-pay. Significantly, this means that no American will be able to choose a health insurance plan that does not cover what is determined to be “preventive care for women.”
Instead of defining “preventive care” in the statute, Congress left this determination to the Department of Health and Human Services (HHS). Tasked with advising HHS, the IOM serves an important role in determining what constitutes “preventive care for women.”
At the IOM’s three public meetings on “preventive care,” groups that were invited to present to IOM on “women’s issues” nearly all took a public stance in favor of abortion. The list included Planned Parenthood, the nation’s largest abortion provider, who stands to gain financially if abortion and abortion-inducing drugs are included in this mandate. This huge conflict of interest was not disclosed at the meeting.
Of course, Planned Parenthood and other pro-abortion groups have been pushing for the inclusion of contraception in the definition of “preventive care” ever since PPACA was passed.
At the IOM meetings, nearly every official presenter urged that all FDA approved contraceptives be included in the preventive care mandate. Such a definition would require coverage for so-called emergency contraceptives, including ella, which can kill a human embryo even after implantation. Thus, if “contraception” is included in the definition of “preventive care,” Americans will be forced to subsidize abortion-causing drugs with their insurance premiums. And that is precisely what we expect the IOM will announce on Wednesday.
Pro-life groups were not invited by the IOM to present at its meetings, but had the opportunity to give brief remarks during its public comment period. AUL attended and delivered comments at each meeting urging the committee not to include abortion and abortion-inducing drugs.
AUL also submitted a written comment to the Department of Health and Human Services regarding its interim final rule for group health plans and health insurance issuers relating to coverage of preventive services under the Patient Protection and Affordable Care Act of 2010.
AUL’s comments included a reminder to the IOM that Senator Barbara Mikulski (D-MD), who offered the amendment that now mandates preventive care coverage, stated on the Senate floor,
“This amendment is strictly concerned with ensuring that women get the kind of preventive screenings and treatments they may need to prevent diseases particular to women such as breast cancer and cervical cancer. There is neither legislative intent nor legislative language that would cover abortion under this amendment, nor would abortion coverage be mandated in any way by the Secretary of Health and Human Services.”
AUL continues to urge the IOM, and HHS, adhere to the Senator’s comments that “preventive care” means to provide screenings and care for American women to prevent disease, not to end pregnancies.
However, given the deck-stacking at the IOM meetings, it seems IOM and the Obama administration are poised to impose on all insurers an obligation to cover abortion-causing drugs and to force all Americans to participate in such plans (if they want to have insurance, that is). This would be a hugely significant restriction of conscience rights and protection.
Given the likelihood that, if HHS includes any conscience protections, they will be quite narrow, Congress must act to permit broad opt-outs for pro-life and conscientious Americans. One good way to do that would be by passing, for example, the Respect for Rights of Conscience Act introduced by Representative Jeff Fortenberry.
There is no issue in DC more important than this, neither the “debt ceiling” nor anything else. Americans must not allow pro-abortion fanatics to impose their beliefs on the majority who disagree through the manipulation of the health care law and requirements.