The following resolution, submitted and reviewed by the Ohio Academy of Family Physicians Executive Committee, has been sent to the Public Policy Committee for consideration during its next meeting on Saturday, November 10.
Per OAFP policy, the Academy is now seeking member feedback on the “resolved” portions of the resolution. Please submit your comments by Friday, November 9. Member comments will be shared with the Public Policy Committee as part of their deliberations. Any recommendation made by the Public Policy Committee to the Board of Directors regarding this resolution will include collected comments from members.
Title: Protect and Ensure Contraceptive Coverage as a Preventive Medical Benefit
Introduced by: Catherine Romanos, MD, and Natalie Hinchcliffe, DO
Supported by: Emily Dagget, MS3; Connor McNamee, MS3; Katrina Timson, MD; Colin McCluney, MD; Emily Dagget, MS3; Jennifer Watson, MD; Jane T. Balbo, DO; Abigail Lowther, MD; Jackie Mostow, MS4; Adarsh Krishen, MD; Roma Amin, MD; Tom Houston, MD; Mary Grulkowski, MD; Rajnish K. Gupta, MD; Sharon Liner, MD; Ean Bett, MD; Patricia Blochowiak, MD; Alexander Curtis, MD; and Kelly Thibert, MD.
WHEREAS: The American Academy of Family Physicians (AAFP) supports policies and legislation that would require public and private insurance plans to provide coverage and not impose cost sharing for all Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women and men with reproductive capacity including those contraceptive methods for sale over-the-counter[1], and
WHEREAS: ensuring access to affordable or no-cost family planning services is a cost-effective public health strategy to address the economic and public health impact of unintended pregnancy and unwanted birth especially with no-cost long-acting reversible contraception (LARC), which has shown to reduce unintended and teen pregnancy rates,[2] and
WHEREAS: the economic impact of unintended pregnancy is significant. The estimated cost of one Medicaid-covered birth in the US was $12,613 in 2008, compared to $257 for the national per-client cost for contraceptive care or $400-550 for a first-trimester abortion,[3] [4] and
WHEREAS: in 2010, the total public expenditure on unintended pregnancies nationally was an estimated $21 billion[5], and
WHEREAS: the economic benefit of contraception use is also felt on the individual and family level. In one US study, 77% of women surveyed who used birth control reported that it allowed them to better support themselves and their families, as well as helped them financially (71%), for education (64%) and getting a job (64%),[6] and
WHEREAS: in addition to the economic cost of unintended pregnancy, the public health impact is dramatic. Access to family planning services allow people to achieve desired birth spacing and family size, and contributes to improved health outcomes for infants, children, women, and families[7], and
WHEREAS: negative consequences of unintended pregnancy include delays in initiating prenatal care, increased risk of maternal depression, increased risk of physical violence during pregnancy and low birth weight infants[8], and
WHEREAS: Healthy People 2020 aims to “Improve pregnancy planning and spacing, and prevent unintended pregnancy,” and states that “Family planning is one of the 10 great public health achievements of the 20th century,” [9] and
WHEREAS: access to affordable or no-cost contraception ensures women of low socioeconomic backgrounds are not unfairly or additionally burdened as they seek reproductive options, and
WHEREAS: access to birth control is key to maintaining women’s’ bodily autonomy, now, therefore be it
RESOLVED: OAFP will support any legislative initiatives that will ensure coverage of all FDA approved contraceptive drugs, devices, and products, as well as voluntary sterilization procedures without cost sharing on the part of the patient, and, be it further
RESOLVED, OAFP will oppose legislation that gives employers the right to restrict coverage based on their own personal beliefs.
[1] https://www.aafp.org/about/policies/all/family-planning.html
[2] http://www.nejm.org/doi/full/10.1056/NEJMoa1400506#t=abstract
[3] http://www.nejm.org/doi/full/10.1056/NEJMp1104373#t=article
[4] http://kff.org/womens-health-policy/issue-brief/coverage-for-abortion-services-in-medicaid-marketplace-plans-and-private-plans/
[5] https://www.guttmacher.org/report/public-costs-unintended-pregnancies-and-role-public-insurance-programs-paying-pregnancy
[6] https://www.ncbi.nlm.nih.gov/pubmed/23021011
[7] https://www.healthypeople.gov/2020/topics-objectives/topic/family-planning
[8] Ibid
[9] ibid
Though I agree with the sentiment, I think the language needs modified. The absolute nature, support all legislation for and oppose all legislation against is problematic. to rigid and puts the OAFP in a corner. Needs to be more nuanced such as the AAFP position. There could be components of any legislation we like in general that we would not like overall due to other aspects and would stay neutral or oppose.
As a listed supporter, I have made it apparent that I support the resolution. In my community, the devastating effects of unwanted pregnancies is so dramatic that I do not favor any sort of modification or allowing any restriction of access. Young women who are not ready to deal with a pregnancy and with motherhood need to have the process of obtaining contraception much easier, and not at all more difficult.
I wholeheartedly support the resolution and appreciate the tireless work and effort of all involved. Access to contraception, or the lack thereof, is an issue that continues to plague my community and many communities.
While I support the objectives of the resolution, I agree with Dr. Wexler’s points about its need for nuance and context.
I appreciate the group considering this resolution and taking the time to comment. To respond to Dr. Wexler and Dr. Houston’s concerns, the first resolved clause calls for OAFP to support legislative “initiatives.” This is not a blanket statement that we must support all legislation. In the case that there is a large piece of legislation that includes pieces we support and pieces we oppose, this resolution does not tie our hands. The second resolved however, does ask OAFP to oppose any “legislation” that would restrict coverage. I hope that this detail in the language makes the proposal more appealing to the committee. Given the slow and steady rollback of so many key aspects fo the Affordable Care Act, it is imperative that OAFP opposes these measures.
Control of reproduction is fundamental to the health and well-being of women and by extension to the families and the children that they may have. I fully support these resolutions in the hope that we can help women have the safest pre- and post- natal health when and if they are ready.
I fully support this. I started practicing before the ACA, and watched how the requirements of the ACA have allowed so many women access to affordable, effective contraception to avoid unplanned pregnancies, and allow them to become pregnant IF and WHEN it is right for them. I have seen young women finish college and start new jobs without health insurance, with effective, safe contraception on board because they HAD insurance in college that allowed them to get an IUD or implant, and have successful careers because of this. We know that when women are able to control IF and WHEN they have children, they can be more successful in life and achieve their goals. I demand that the OAFP support this resolution that will allow women to be in control of their fertility.
Although I am not an FP, I am on the Ohio network cluster. I am a pediatrician who deals with unintended pregnancies in my patients regularly. I agree with this resolution as a mother, wife, pediatrician, professional woman, and a human. It clearly provides evidence to support itself. I think that professional women feel strongly for this type of legislative action, because of it weren’t for available birth control, many of us might not be in the position we are today. Thank you and I hope that you can reach out to Ohio AAP to garner added support. I do not have connections there, but offer it as a suggestion for perhaps another physician group to sign on.
I completely agree with this resolution. As a physician who practices in an area where unintended pregnancies are all too common and infant mortality rate are entirely too high, we need to ensure our patients have access to affordable or no-cost contraception options if we hope to have any chance at improving these outcomes.
I oppose this legislation as it appears to require OAFP to take a pre-defined stance on issues that sharply divide our society. Supporters and detractors of these issues passionately present highly emotional arguments that support health, well being and life. Both sides present data to show that their stance supports the physical and emotional well being of individuals, yet this resolution only considers one side of the arguement.
Further more, this resolution would require OAFP to support legislation that forces employers to financially support actions that may go against their moral beliefs. While I support equal rights for all, I feel we need to take pause when the rights and freedoms of one individual arguably interferes with the rights of another individual.
In short, I do not feel the OAFP should take a absolute one-sided stance on a topic that has so sharply and emotionally divided our society. We risk appearing to align with given segment of society and perhaps even a specific political party. We would be very close to identifying as that segment of society, or worse, that political party.