Over the past several months Congress has been working at a fast pace to get comprehensive health reform legislation to the President's desk before the end of this year.
Two Senate committees are working on bills which they will ultimately merge into one and send to the full Senate for a vote sometime before Congress adjourns for the August recess.
Meanwhile, there are three committees in the House that are working on health reform. The House committees are collaborating to produce one bill, which is also expected to be voted on by the full House by early August. Broad outlines of a "Tri-Committee" draft bill were circulated last week.
Looking at the various draft proposals that have already been released, it is clear that Congress is making a historic effort to reform health care, as is the Obama administration. Yet with so many "big picture" issues to grapple with, like spiraling health care costs, access and affordability, employer mandates, taxing benefits, and whether to include a public plan option, it's hard to get Congress's attention on some of the "smaller issues," such as pregnancy planning and prevention. However, pregnancy planning and prevention affects the lives of most Americans who would benefit from health reform, and therefore, is very much a part of the "big picture."
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Consider this: Half of all pregnancies in the United States are unplanned. We know that family planning services are widely used and broadly supported: 98 percent of sexually active women have used some form of family planning. Pregnancy planning and prevention is also cost-effective. Contraceptive use saves nearly $19 billion in direct medical costs each year. And if politics are the issue, 88 percent of voters support women's access to contraception, and 72 percent of Republicans and Independents favor legislation that would make it easier for people at all income levels to obtain contraception.
Given the health, economic, and social consequences of unplanned pregnancy, Congress should pass health reform that: (1) includes pregnancy planning and prevention as an integral component of any basic benefit package; (2) complements private sector health initiatives with strong, publicly-financed family planning services for those individuals who do not otherwise have access to high quality, affordable family planning; (3) encourages responsible behavior among men and women by including pregnancy prevention within the broader scope of prevention and wellness; (4) strengthens the practitioner workforce through enhanced education, including education about new long-acting reversible contraceptive methods; and (5) improves young adults' access to affordable health insurance.
There is also the question of personal responsibility as part of health reform. At a recent town hall meeting in Green Bay, Wisconsin, President Obama responded to questions about how health reform would incorporate wellness and encourage people to take more responsibility for their own health care. The President affirmed how we all have to do our part - families, government, employers, insurance companies and others. Although this usually comes up in the context of smoking, diet, and exercise, the notion of shared responsibility applies to pregnancy planning and prevention as well. Reducing unintended pregnancy requires responsible behavior and choices by both men and women, and responsible policies on the part of the public and private sectors. Health reform presents an unprecedented opportunity to make progress on this idea of shared responsibility.
Health reform that leaves out or inadequately addresses an issue that affects most women and men and families in this country is not real health reform. And certainly, health reform legislation that includes women's health, prevention, and health promotion, but does not include access to high quality family planning services - gynecological care, contraceptive counseling, access to all FDA-approved contraceptive drugs and devices, and related outpatient services - falls short of real reform.
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Health reform must include pregnancy planning and prevention services, which will improve health, strengthen families, improve child well-being, enhance our workforce, and reduce taxpayer burden. With fewer unplanned pregnancies there will be less poverty, more opportunities for young men and women to complete their education or achieve other life goals, fewer abortions, and better prospects for this generation and the next. Isn't that the "Big Picture?"