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Viewpoints: Women should have full choice of contraceptives

More than 99 percent of women use birth control at some point in their lives, and more than half of all pregnancies are unintended. For many women, their first entry into the health care system is to obtain contraception.

That’s why Congress required insurance companies to cover the full range of Food and Drug Administration-approved methods of contraception with no out-of-pocket costs as part of the Affordable Care Act. Nearly 30 million women across the country have benefited from this provision since it went into effect in August 2012.

Last week, the U.S. Supreme Court, in its highly anticipated decision in Burwell v. Hobby Lobby, ruled that “closely held” for-profit corporations can deny birth control to their employees if company owners are against some forms of contraception due to their religious beliefs. In doing so, the conservative justices in the majority failed to recognize birth control as basic preventive health care for women and took an alarming step backward for women’s health.

Fortunately, women in California are largely protected against this regressive decision thanks to the Women’s Contraceptive Equity Act, passed in 1999 and upheld by the state Supreme Court in 2000. This law, one of the first of its kind, requires employer-based health plans that cover prescription drugs to also cover birth control. The law has a very narrow religious exemption that applies only to institutions such as churches.

The contraceptive equity law was pioneering when originally passed and continues to protect birth control access in our state, despite the recent U.S. Supreme Court ruling. However, after 15 years, changes are needed to ensure not only access, but access to the method of birth control a woman believes is best for her.

That’s why Sen. Holly Mitchell, a Los Angeles Democrat, introduced Senate Bill 1053 – the Contraceptive Coverage Equity Act – this session. The bill seeks to codify into California law the no-cost contraceptive coverage provided for in the Affordable Care Act and to restrict “medical management” techniques employed by health insurance plans that create barriers to accessing particular birth control methods.

Health insurance documents and reports from patients reveal a wide variety of practices leading to a patchwork of contraceptive coverage policies across the state for enrollees in private and public health plans. Some plans limit or exclude the most effective birth control methods available, such as intrauterine devices, while others impose co-pays on the contraceptive ring and patch. At least one California insurance carrier excludes the emergency contraceptive Ella from its no-cost list, despite the fact that it is significantly more effective in women with higher body mass indexes than other emergency contraceptives.

According to medical standards of care, a woman’s choice, in consultation with her provider, should be the primary factor in determining her contraceptive method. Employers and health plans should have no role in this private medical decision. That’s why we need the Contraceptive Coverage Equity Act.

California has a long history of supporting women’s health and reproductive access. SB 1053, which passed the Senate in May and is before the Assembly Appropriations Committee, continues the state’s leadership in expanding and protecting birth control access and reducing unintended pregnancies. The California Health Benefits Review Program estimates that SB 1053 could prevent more than 50,000 unintended pregnancies, and in turn save the state nearly $150 million in the first year of implementation alone. It’s a step forward for women’s health and a win for California taxpayers.