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Covering contraception makes sense

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When the federal government considers which preventive medical goods and services should be fully covered by insurance under the healthcare reform law, the prevailing issues should be reducing costs and providing maximum choice to the patient. The Institutes of Medicine adhered to that principle with its recommendation last week that insured women should be able to get contraceptives without a co-payment or deductible.

Close to half of all pregnancies in this country are unplanned, and about 40% of those result in abortions. In addition, according to a University of Michigan study, a third of all births in the country are unintended. In many cases, those births are nonetheless welcomed, but studies have found that pregnant women are more likely to smoke and drink during an unplanned pregnancy, two activities that are dangerous to the fetus, and that they tend to be less attentive to the babies born of such pregnancies.

Abortions and unwanted pregnancies are not only more expensive than contraception, they are sad events in a family’s life. Removing the financial barriers that keep many women from using contraceptives is both smart preventive medicine and a social good. The Obama administration has wisely indicated that it will adopt the recommendation.

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The Roman Catholic Church and conservative religious groups predictably object, seeing this as a government endorsement of contraception. Pregnancy is not a disease, they note, and most preventive care is aimed at warding off medical problems.

But once a medication or medical device is approved by the U.S. Food and Drug Administration, it should not be treated differently by the government, or by insurers, based on religious beliefs. The person who should make the decision on whether to use contraception is the patient. Fully covering the cost of contraception — along with fully covering prenatal care for women who want to have a baby — is the best way to respect differing beliefs and reduce medical expenses while giving women the right to make a personal medical choice.

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