Preventive services under PPACA. Do they include contraceptives and family planning?

Under the Patient Protection and Accountability Act preventive services will be covered at 100%. The concept is to remove all financial barriers to these services in the hope of long-term savings through avoided future costs. That’s fine in concept, but in the process we are undermining the very purpose of insurance and further removing the individual from concern over health care costs. Oh well, that ship has sailed and I’m not on board.

However, defining preventive services is still up for ongoing debate. For example, should health plans be required to cover services for women’s reproductive health? The Obama administration is exploring whether health plans can and should be required under the health reform law to offer contraceptives and other family planning services free of charge. For employer plans, this may mean having to cover contraceptives at 100% without any member co payment, coinsurance, or deductible.

According to Conner Strong, it is likely that health plans may not incur much additional cost for mandated contraceptive coverage in and of itself, but it could become a significant issue in relation to total costs incurred for all preventive services. Plus, mandated coverage of contraceptives may end up among the aggregate of costly new benefit mandates being evaluated by the Institute of Medicine (IOM) panel. 

It seems to me the real issue is what the heck are we doing? How does such a strategy lower health care costs, improve quality or make health care more affordable? Where does it end? As I have questioned many times, where is the logic for covering such services under health insurance let alone at 100%?

One of the main drivers of health insurance costs is the numerous mandates imposed by the states. Some estimates put those costs at 25% of premiums. If we are going down this road at high-speed at the federal level we are on a crash course, especially if the mandates go beyond providing coverage for the expenses related to treatment of illness and injury

More on this issue can be found on the Conner Strong website