In order to understand the controversy surrounding the coverage of birth control for women by health insurance providers, it is necessary to take a larger look at the issue of reproductive rights. Many women feel that they have earned the right to coverage for birth control by being an integral part of the workforce, especially since so many male sexual issues are addressed by health insurance companies. However, there are also those who feel that certain methods of birth control may violate their religious or ethical principles, and these people often see forcing employers to provide health insurance coverage that pays for birth control as an unfair use of government power.

Invasive vs. Non-Invasive Forms of Birth Control

There are several popular methods of birth control for women. Some of these methods are very subtle and non-invasive, while others are more controversial. Methods of birth control generally accepted by most people as being ethically sound are:

  • Oral Contraceptives - With an effectiveness of up to 99 percent, “the Pill” is one of the most popular birth control choices. Oral contraceptives can also be used to control heavy menstrual periods or cramps. However, oral contraceptives do contain hormones, making them an inappropriate choice for some women. Women who smoke or are over 35 also have a higher chance of developing blood clots when using oral contraceptives. Many health insurance policies have some form of coverage for birth control pills.
  • Condoms – Condoms are generally not covered by health insurance as they are over-the-counter items that do not need a prescription for purchase. However, you may be able to use funds from a healthcare savings account toward the purchase of condoms. One advantage condoms have over other methods of birth control is that they can be used only when needed and they have no serious side effects. They are also the only form of birth control that is somewhat effective at preventing sexually-transmitted disease. However, they are also not completely reliable; a small hole or tear in a condom renders it essentially useless.
  • IUDs – IUDs are often covered by insurance plans, although some plans that will cover oral contraceptives refuse to cover IUDs because of the higher cost. IUDs are very effective at preventing pregnancy but can have serious side effects if they become dislodged or expelled.
  • Birth Control Shots, Patches and Rings – Along with the Pill, other forms of hormone-based birth control include shots, patches placed on the body, and vaginal rings. Insurance companies may cover all or none of these options.
  • Diaphragms – When used properly, a diaphragm is very effective at preventing pregnancy. However, they are very easy to misuse and must be replaced at regular intervals to prevent pregnancy effectively. Some health insurance providers cover regular replacement of diaphragms.

Invasive methods of birth control, or those that require far more medical care and are therefore more expensive, include:

  • Tubal Ligation – Female sterilization is a popular choice for women who have already had children. Doctors are reluctant to perform the procedure on anyone who has not already had a child because the operation cannot usually be successfully reversed. Many insurance companies will pay for tubal ligations, especially in the course of another operation such as a C-section. However, due to the high cost of the procedure and the possibility of a hospital stay during recovery, some insurance companies refuse to pay for this operation.
  • Abortion – The early termination of a pregnancy, known as abortion, can be performed in several ways. In vacuum abortion, the fetus is removed through the use of a vacuum tube. In a D&C operation, the fetus is removed through a dilation and curettage procedure. Many insurance companies are reluctant to provide coverage for abortions. For one thing, the procedure can be classified as medically dangerous; a simple mistake could render a woman unable to have children in the future, although this only happens in a very small percentage of abortions. Another reason companies may be reluctant to provide coverage for this procedure is that the cost is relatively high when compared to preventative methods. Finally, some employers have religious or ethical convictions that prohibit them from agreeing to health care coverage that permits abortion.
  • “Morning-after” Pill – There are two major types of “morning-after” pills on the market. One treats a woman immediately after sex and prohibits the fertilized egg from implanting. Another, known as the “week after” pill, can be used for a longer period of time after unprotected sex—in most cases, up to five days later. Neither of these pills are the controversial RU-486, an oral abortifacient. The new provisions of the ACA do not provide for RU-486 to be offered to women free of charge.

What Will the Affordable Care Act Do?

The new Affordable Care Act will require health insurance companies to provide all forms of birth control to women without co-pays, with the exception of abortions and abortion-producing drugs.

If your birth control is not covered right now by your health insurance, the ACA will soon require your company to provide you with options free of charge.