Last week, the White House announced health insurers would have to cover the cost of providing free birth control to employees of religious groups as part of the Affordable Care Act, which requires health insurance plans to offer contraception without charging a co-pay, co-insurance or deductible as of August 1. The rationale was that any added cost would be offset by fewer unwanted pregnancies.
A new survey, however, indicates that health insurers disagree - 40 percent say that monthly costs per member will rise through higher pharmacy expenditures within two years after the ACA preventive care requirement goes into effect. Another 7 percent expect higher pharmacy expenditures but lower medical costs, while 20 percent say costs will balance out and 33 percent are unsure.
"The real question is whether (the preventive requirement) will really save money in the long term by preventing pregnancies, which are expensive. But at this point, most payers are not convinced that they're going to save money," says Rhonda Greenapple, ceo of Reimbursement Intelligence, a market research firm that queried 15 large health insurers that cover tens of millions of Americans.
All of the health insurers reported that their customers - which include employers and unions, among others - currently offer to cover contraception in some fashion, although employees are asked to make co-payments. These typically vary, depending upon the product, such as whether a birth control pill is a brand-name med or a generic.
For drugmakers, the mandate may prove profitable, but could also pose a "double-edged sword," according to Greenapple. On one hand, a mandate suggests the possibility of additional prescriptions being written for women who may not otherwise opt for the medications. However, insurers may then pressure drugmakers for steeper discounts.
Not everyone, however, believes insurers will suffer. "In the grand scheme of things, it doesn't seem like a material cost to be added to the managed care company or the employer," Stifel Nicolaus health insurer analyst Tom Carroll told Reuters. "Any services that are mandated are ultimately covered in the premium, either to the specific group or to the system in general." In other words, increased premiums would cover increased costs.
pic thx to treyevan on flickr
63 Comments
It just occurred to me that there is another possible market distortion from this to consider: favoring prescription forms of birth control over condoms, though the latter have an important public health role in prevention of STD transmission. It is possible that if this drives birth control practices away from condoms that there will be other public health impacts, even if unwanted pregnancies are reduced?
May I observe that there is one cost savings not addressed? If a birth is avoided, the insureres "practice cost avoidance" related to additonal 'customers.' After all, new infants tend to also be 'consumers' of health care. The savings are more than just avoiding the delivery costs it's also "the upkeep" ....
I'd like to see a detailed cost analysis of the premiums that are part of employers plans which include contraceptives under their plans/on formulary compared to those for the religious institutions that specifically exclude contraception in their prescription coverage. I find it hard to believe there is a significant difference in the premiums and this kind of undermines their statements that, in allowing the number of employees to opt in and fill monthly prescriptions for contraceptives, the cost they pay to reimburse these meds would have an actual impact on their bottom line. They already push patients to the cheapest meds through formulary, tiering of co-pays and mail-order pharmacies
@Eric - the cost to treat most STDs is lower than the costs associated with pre-natal care, labor & delivery and well baby care, not to mention the additional costs to the child that is born. Unless you have some stats that show women become HIV positive with illness when using hormonal contraception more often than they become pregnant without hormonal contraception. . .
Additionally, many women who are concerned about STDs when not in what (they think) is a mutually exclusive committed relationship do often use condoms (even in addition to the pill). It's difficult enough to get a man to agree to use a condom; it's even more difficult to get him to do so when you're in (what you think is) a mutually exclusive committed relationship which is one reason why women prefer to rely on a prophylactic that is easier with regard to compliance and control
This whole birth control mandate is ridiculous. It will put women at risk for the potential side effects of invasive contraception when, as Eric pointed out, condoms pose no risk of side effects and are as effective. Condoms are also cost effective and, as Eric also pointed out, protect users from actual disease states like HIV or heroes infections.
Another short sighted, idiot move by the government.
I agree with Eric on the need for barrier contraception, in case "one slips past the goalie".
If the insurers of the Catholic employers have to provide "free" insurance, it's just like the Catholic employers provided it. And that violates the Catholics' First Amendment rights.
All this talk about "savings" and "free" is besides the point.
@xmrk - May I observe that "the market" has chosen oral contraceptives over "barrier contraceptives" - it was not the government. (Said market includes the practicing Catholics as part of the population.)
In addition, Catholic Church teachings banned those "single-use medical devices" long before "the pill" became available. To partially quote Mark Twain - "Facts are stubborn things ..."
Considering what the approval rating is for *congress*, and *for-profit health insurance companies*, I waited until the antiemetic kicked in before dealing with the *feeling* behind those polls before calmly addressing this latest secret billionaire nimrod's ram-rod-ing of the bedroom door in the political season.
Take all the $$$ that was paid out for ED medications at one time, put it in the contraception column. That's all you need to do and then the rest of the *math* should be the same.
@Observers - my comment has nothing to do with the Catholic church, sorry. Also, the differences between what 'the market' chooses and what (insurance) companies should be coerced to provide FOR FREE have nothing to do with one another.
This mandate is ridiculous. It is very similar to Obama's demand on cable and cellular providers to give away their services to the 'under privileged' because, apparently, having cable and a cell phone is a right others should pay for - and now prescription drugs, too. This is one slippery slope insurers are being greased to slide down.
Any bets on how long it takes law firms to include insurance companies as defendants once they start giving away products involved in class action product liability lawsuits?
To add to what xmrk wrote, the mandate for free contraceptives applies to minors too. Does an insurance company, forced by this legislation to provide "free" Jaz to your 10-year old, have any liability in the event of injury? Did anyone involved in this think this through?
Just because 98% of Catholic women use contaceptives, so what? 98% of people put mustard on their hot dogs. Does that mean someone else should pay for my franks?
Inevitably the "forgiven" cost of contraceptive coverage to the Catholic Church and other religious organizations in opposition, will be passed along to every other employer and will be "hidden" in the cost of increased premiums to Church and secular employers alike. What goes around, comes around...there is no free lunch!
The government cannot give to anybody anything that the government does not first take from somebody else.
Bottom line is now the public is subsidizing sexual as a right. I am waiting for the first court case were a rapist claims he has a right to have sex because he is paying for it through his taxes!
As a pharmacist, I very often got the call "What do I do when I forgot to take my pill." The same people that get unwanted pregnancies (contraception available or not) are the same people that will get free healthcare, free birth control pills, free pre-natal care, free head start programs, free school breakfast-lunch-dinner, free food stamps, free head of house tax paybacks, free housing, free college education and on and on and on because....this is the land of the free!
I love all the men on this site who ignore the obvious - you expect these same insurers and employers to cover your medically UN-necessary ED treatments. You scream foul when women want access to birth control and their proven medical benefits - i.e., PMS reduction, prevention of ovarian cysts and reduction in ovarian cancer risk, etc. Just how does your ED treatment advance medicine exactly?
FPI, it's been a while now that third party payers have cut way back on the number of Viagra tablets they will cover as well as other ED meds. In most plans it is no more than six tabs/month. Same thing with most Medicaid formularies. In fact some states have dropped coverage entirely for ED treatments. I guess poor folks have more important things to worry about than sex.
A fundamental difference between the ED coverage and birth control is that the government is now REQUIRING insurance companies to GIVE AWAY the birth control. Under the law birth control will have no copay, not be part of any deductible or Max coverage calculation.
This is not just for religious organizations as people seem to get hung up on here about this topic in general - it is for ALL who have insurance coverage, which under the mandate will be just about everyone. Scott the pharmacist is exactly right with his assessment of where this is going.
xmrk, this will wind up as another example of the Obama shafting of the PCOA (Paying Customers of America). Nothing is really free; the costs will be shifted to the paying folks like me. Already my health insurance premium has gone up $30 in one month, I'm sure in part to cover this stuff.
First, mark my words, costs will not go down, unwanted pregnancies and therefore, abortions will not go down. Certain public health care systems such as NYC Health and Hospital Corp. thru its 11 hospitals w/ outpatienmt clinics and numerous free-standing health clinics have been giving out free birth control for decades - pills, Depo-Provera, IUDs, implants, the patch, condoms, female condoms, NuvaRing and anything I may have left out and guess what HHC performs thousands upon thousands of medical and surgical abortions a year. There is a subset of our population that uses abortion as bith control. The is also a cultural subset of both men and women who want babies because it is a sign of womanhood or machismo. Free birth control for all will not "correct" these problems. And by the way there is never, ever a "free-lunch." Anything provided free by government is paid for eventually by the people via taxes (this is basic economics 101 as they say). Governments over spend via defict spending, ie, they borrow (by issuing bonds, the feds call them treasuries) money; now we the tax payers have to pay back the loan and the interest on the loan. Why do they borrow? Because they over spend. Many of us do that too. You have $500 in checking but you want that 55" flat screen for $1300. You charge it, you pay off $500 of the bill with your $500 and now you're left with $800 on the charge card that you have to pay back with interest - deficit spending. You have to work more to pay it off. The government has to tax more to pay it off ... your money again.
With regard to religous organizations ... the real issue has nothing to do with contraception. The liberals want to make it appear that conservatives are against contraception ... that they are neanderthals and that is the issue, but this is not the REAL issue, it's a false premise. The issue is not about contraception, no one is against contraception. The issue is government overreach into our individual lives-telling us what we can and cannot do. Health care is the opening to CONTROL YOU and everything YOU do. And it's already happening, can't eat fat, sugar, alcohol, can't smoke, etc. Soon, can't drive an SUV, not due fossil fuel but because they cause lung cancer. (Don't forget coal burning power plants cause lung cancer too so electric cars won't help. And nuclear power plants do too.)Can't play dodge ball in school may have head trauma. Can't have a baby- too many people (ie, China). Can't have a baby girl they're not worth as much (ie, India). Blonde w/ blue eyes, no tanning booth for you-skin cancer. No swing sets, monkey bars, balance beams in playgrounds-you may fall off and break an arm. No sgar, diabetes. No french fries, heart failure. Soon you can't do sh*t without permission from the government. You know, back in the day of the '60s the protests were anti-government, now we're protesting for more government control? We're well on our way to surfdom ...
"The liberals want to make it appear that conservatives are against contraception … that they are neanderthals".
Check this quote: We’ll repeal Obamacare and get rid of the any idea that you have to abortion coverage and contraceptive coverage. One of the things I will talk about that no president has talked about is, I think, the dangers of contraceptives in this country. The whole sexual libertine idea. Many in the Christian faith have said, ‘Contraception’s okay.’ It’s not okay. It’s a license to do things in the sexual realm that is counter to how things are supposed to be.”
That quote comes from a certain ex Senator from Pennsylvania, now a GOP presidential candidate, in a 2006 interview with blogger Shane Vander Hart on Caffeinated Thoughts.
Yo, you should check your sources next time you put out the next one of your rants.
Original II - that quote is taken out of context. No one has suggested that they'll be no access to contraception or abortion coverage. The debate is not about contraception or abortion it's about whether or not our government can order you to pay for something you don't believe in; and in this case it happens to include religion and the First Amedment ... it does cut both ways you know. The media certainly wants it to appear to be a debate about contraception. Why did Geroge Stephanopoulos pull this out of thin air back in January when there are so many more important things to discuss? A setup? This is an attack on our freedom and health care is the Trojan Horse.
By the way, OII, it looks like we're in agreement in what's going on here.
OII, here's another rant. "Free" contraception and abortion on the public dole? Yes! Absolutely. Viagra, Cialis, etc. on the public dole? Absolutely not!
Absolutamente agree.
My question - why do I have a co-pay for blood pressure medication or asthma medication that can keep me out of a hospital potentially saving money overall, but, contraception must be no charge? Does anyone other than me see the real issue here? It is not about health care cost or even access to contraception (which is not a real problem.) It is the social agenda of the left.
@Former Pharma Insider: "Just how does your ED treatment advance medicine exactly?"
Viagra isn't only used for ED. It is now medically useful/prescribed after prostate surgery -- lots of papers in the medical journals on this. Will be happy to provide links if anyone wants to read more. It keeps the blood flowing after certain nerves have been cut. Nothing to do with sex, or sexual performance. More to do with preventing atrophy. There is a big thread on the NYT Health Blog about post-prostate surgery problems, in which many of the men complain that their insurance companies limit reimbursement for this -- if they're lucky they get what oii said above, 5/6 pills a month.
To another point in your post, nobody is proposing to limit women's "access" to contraceptives.
Yo wrote, "...We’re well on our way to surfdom..."
Gnarly, Dude! Serf's UP!
Thanks for the chortle of the day...
Anyone ever try to collect data on how many un-wanted pregnancies could have been avoided among 10 year old girls if 50 year old men did not have ED meds?
On the subject of cost, I watched an interview with Rep. Debbie Wasserman Schulz (sp.?) yesterday, in which she said that contraception costs per woman typically run $700 to $800 a year.
Dear old enough, it's all about whose ox is being gored. Accept for discussion sake the premise that college kids are a huge swing voting block. Until recently it has been the policy of a local university to offer free condoms at the student health center. They were in a large cookie jar in the lobby, free for the taking. After it was found that students were literally walking away with fistfuls of condoms the school stopped giving them away.
In short the move caused a near riot on campus, which I suppose says something also about today's college kids priorities.
You have to clearly understand one thing about the GenY'ers. IT'S ALL ABOUT FREE STUFF. They will absolutely remember any politician who stood in the way of their free sex, drugs and Radiohead.
George, tell Debbie what she already knows. The cheapest form of contraception is an abortion. Planned Parenthood will pick up the tab for the procedure and your cab fare back home. No muss, no fuss.
Boy, are those GenY'ers in for a surprise. What 'til they get their first bill for the insurance mandate, in which they subsidize the oldies and everybody else's "free reproductive healthcare" and "free preventative care."
They'd better wise up before the IRS comes a-knocking.
Yep, George, they like to talk about becoming change agents, but another rude surprise for them will be that with projected job trends, the only thing that will change for them will be them changing my diapers in the nursing home, which by the time I hit the front door will be anything but free.
"it’s about whether or not our government can order you to pay for something you don’t believe in"
the answer to that is, was, and always shall be "yes"
"Bottom line is now the public is subsidizing sexual as a right. I am waiting for the first court case were a rapist claims he has a right to have sex because he is paying for it through his taxes!"
you, sir, are disgusting beyond words.
and oii? any lingering "benefit of the doubt" I had about you is decisively gone. you are obtuse, sir. good day.
Thanks for sharing, Harpy. That's why the correct spelling of the next president is S-A-N-T-O-R-U-M. Andy once Rick is president we will be spelling Roe v Wade as H-I-S-T-O-R-Y.
ah yes, the sweater vest antichrist who seeks to nail shut the coffin of the American dream. good luck with that.
In that case, let's join the millions of single parents having out of wedlock children with a rousing round of Paul Anka:
http://www.youtube.com/watch?v=8QN6p66AtDc
--“it’s about whether or not our government can order you to pay for something you don’t believe in”
--the answer to that is, was, and always shall be “yes”
=============
If the answer to that is "yes" then what does the First Amendment mean? You have a right to free exercise of your religion until somebody doesn't like what that entails? You only have free speech until somebody doesn't like what you're saying? Your rights are determined by some kind of numbers game, and can be taken away if they don't mesh with the majority opinion of the day?
@George - you already don't have *First Amendment* rights when employed by global corporate masters - so where do you expect to have *rights* when there is no separation of *business* and *State*?
@dzieczko,
Sorry, but I don't understand your response.
I'm sorry to hear that, George. Brave of you to admit to a limit in understanding *First Amendment* rights.
Maybe this will help - whistleblowers who exercised their *First Amendment* rights at work (ie. like not signing off on a bad batch) were punished in a variety of ways, weren't they? Employer rights trump employee rights.
"You have a right to free exercise of your religion until somebody doesn’t like what that entails?"
um, yes. the First Amendment is apparently many things but it does not give you the right to run around like a little anarchist doing whatever you will. if your religion tells you that your faith will cure your sick child and the child dies, you will be held responsible. likewise if your religion tells you you can have as many wives as you like even if they're only 14, you will face prosecution. and if you take it upon yourself to murder someone who performs legal operations because you think god doesn't like it, you'll spend the rest of your life in prison.
@dzieczko
It was the phrasing of your answer I didn't understand. No bigee.
The First Amendment gives you the freedom to speak out -- it doesn't mean there are no consequences of doing so. We have slander and whistle-blowing statutes to address two of the scenarios in which people can be harmed by free speech -- one serves to protect the target of free speech, and one is for the person who engages in free speech.
@harpy On your points, you are bringing other people (child and wives), who have Constitutional rights of their own, into the equation. Like the old saying goes, "My right to swing my fist with impunity ends when it hits your nose." So, the religious adherent does not in this country get carte blanche to commit crimes, such as murder and forced marriage, that violate the Constitutional rights of others. But, they otherwise get to freely practice that religion -- and there are exceptions in many Federal laws to allow them to do so.
The First Amendment does not give me the freedom to speak out. The freedom to *speak out* is what most people still believe is an *inalienable* right granted by the Creator (and I am coming from the observation that we did not create ourselves, so even from that viewpoint, the fact that we evolved a biological mechanism, from the Big Bang, to speak makes it a *fact of existence* which could be romantically referred to as an *inalienable right*).
You are correct in observing that people have consistently attempted to proscribe *inalienable rights* when the *consequences* aren't to their liking. History on that consistent feature of social engineering begins with the savage lust to cut out a person's tongue or cut off their hand, wha'ever, for not signing off on a bad batch :-) Targeted financial ruin is a modern equivalent. So no progress from savagery can be discerned, just the means to achieve the same ends have changed. Kind of makes you wonder who programmed *reality* after the Big Bang, don't it? We can't get away from savagery as a means to *get mine*...
It also makes you want to take a second look at the benefits of medical research being protected as a science-driven culture where a bad batch is a learning experience, but that could just be me...
dz, sinces we're talking sexual libertarianism I suppose that it's one of those inalienable rights for The Girl Scouts of America to take a pro-abortion position in conjunction with their bed buddies over at Planned Parenthood (see link)
http://www.ibtimes.com/articles/286922/20120124/girl-scouts-banned-virginia-church-alleged-planned.htm
"Targeted financial ruin is a modern equivalent."
You make a very interesting point. And the targeted financial ruin aspect cuts both ways. It can come to an individual/organization wrongly accused of something, or it can come in the form of revenge, to an individual/organization making a truthful accusation of wrongdoing.
Powerful stuff.
@oii - I must pull a *george* here and admit to not having any idea what *sexual libertarianism* could possibly be or whether such a thing exists in nature or just in your brain :-)
The human species has two sexes - male and female. Start there, please, if you choose to explain it...
@George - Sense of fair play is a good thing. Two wrongs will never make a right. But with the amount of *yellow journalism* parading around on the internets, things aren't getting any clearer, are they? I always perceived *shorting* to be an *investor* ploy for targeted financial ruin because it was never cleared up whether the management that was embedded into the corp was there to make all the wrong decisions that were known, through previous industry experience, to be what would ruin a company (ie. spinning/not collecting/ omitting/fasifying data). Which means that punishment of *whistleblowers* was just part of the evolving *short* schtick in play and nothing to do with revenge. Nothing personal, in other words...
dz, forget the phrase "sexual libertarianism". For God's sake can someone please explain to me why Girl Scouts of America has any ties to Planned Parenthood? How much of the money I give to my neighborhood Girl Scout for a box of cookies is going into some abortion provider's pocket? I think we have a right to know these things, but non-profits are experts at burying undesireable data.
omg, dz, have you invented a new expression -- pulling a george?
Pulling a george -- when you have to admit that you have no idea what the other guy is getting at.
Have at it.
@george - and we'll have to come up with a catchy phrase for when a person finally admits that he doesn't know what the heck he is talking about :-)
@oii - a self-proclaimed retired multi-millionaire, like yourself, more interested in what the Girl Scout does with her cookie money than what happened to *missing* trillions in the fog of war? Creepy, OII.
re: Girl Scouts and Planned Parenthood
1) it's a lie http://www.csmonitor.com/USA/Politics/2012/0222/Indiana-lawmaker-slams-radicalized-pro-abortion-group.-Yes-Girl-Scouts
2) it's a sick, twisted attempt to slander two non-profit organizations whose only purpose is to support and empower girls and women and to promote our general well-being
3) why would it matter if it were true?
@harpy - it's about the money, nothing else.
So many Ponzi schemes blew up at once and now it's a mad scour for pennies and one of the last big rivers of money that flow daily that hasn't been diverted elsewhere is *health care* - everyone has a chance to take from that cookie jar without putting anything back in...
oii is fanatical about tracking every cent that leaves his *cold dead hands* (to borrow a phrase from the gun nuts) and that poor Girl Scout took a cent from him and she will never have peace, again, until the cookie money comes back to him...let's just say people are *religious* about diverting funds to *private* causes...
It's about the $$$$ - nothing else.
dz, when I pay for my box of Girl Scout cookies I know most of it will be wasted on overhead as is the case with non-profits. I don't think that it's too much to ask for the few remaining pennies to go towards promoting scouting as a healthy lifestyle instead of going to an organization that will show nine year old girls how to put a condom on a banana.
For that reason alone they will have to pry my coins out of my cold dead hands.
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