Member Feedback Requested on Contraceptive Coverage Resolution

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