Fox contributor Charles Krauthammer falsely claimed that the Obama administration “arbitrarily” determined that the Affordable Care Act's (ACA) preventive services requirement must include contraception. Krauthammer's claim ignores that the ACA includes contraception as a preventive services requirement for women, and dismisses the fact that contraception is an integral form of preventive care for women.
Following the June 30 Supreme Court decision that closely held corporations cannot be required to provide health coverage that includes contraception, Krauthammer asserted that the Obama administration “arbitrarily” decided that the ACA's mandate that employers provide preventative care should include birth control, “as if pregnancy is a disease to be prevented” :
But Krauthammer's misguided analysis ignores that the ACA's preventive services requirement includes preventive health care specifically for women, which the Health Resources and Services Administration (HRSA) defines as including contraception.
Justice Ruth Bader Ginsburg's dissent to the Hobby Lobby decision lays out the process through which the law was revised to include contraception, documenting that the initial form of the ACA “left out preventive services that 'many women's health advocates and medical professionals believe are critically important.'” To correct this oversight, Sen. Barbara Mikulski introduced the Women's Health Amendment, “which added to the ACA's minimum coverage a new category of preventive services specific to women's health.” This amendment tasked the HRSA with developing guidelines for preventive care. Together with the Institute of Medicine, which convened a group of independent experts, HRSA determined that women's preventive care should include the “full range” of FDA-approved contraceptive methods.
Unlike Krauthammer, the HRSA's guidelines for preventive care recognize that contraception is a key preventive care measure for many women nationwide. Family planning is critical in helping women prevent unintended and potentially high-risk pregnancies, and reduces the likelihood of dangerous clandestine abortions in the event that legal abortion is inaccessible. From the Guttmacher Institute:
Providing women with high-quality care during pregnancy, delivery and the immediate postpartum period is obviously essential; however, less obvious--if not, in fact, counterintuitive for some policymakers--is the central role that family planning plays in improving maternal health and birth outcomes. Contraceptive use helps women prevent unintended and often high-risk pregnancies, as well as reduce the likelihood of abortion, which is critically important because so many women who have unintended pregnancies are maimed by or even die from septic, clandestine abortion.
The federal Healthy People series, updated every decade by the Department of Health and Human Services to set official public health goals from the U.S., likewise cites the importance of contraception in preventive care:
Unintended pregnancy in the United States is serious and costly and occurs frequently. Socially, the costs can be measured in unintended births, reduced educational attainment and employment opportunity, greater welfare dependency, and increased potential for child abuse and neglect. Economically, health care costs are increased. An unintended pregnancy, once it occurs, is expensive no matter what the outcome. Medically, unintended pregnancies are serious in terms of the lost opportunity to prepare for an optimal pregnancy, the increased likelihood of infant and maternal illness, and the likelihood of abortion.