HB18-1438: Health Care Coverage Reproductive Health Care

Requires all individual and group health care plans to provide coverage for women’s preventative health services (which include screening for gender-specific cancers, expanding on what is currently required, and some counseling for genetic or STDs), abortion as permitted by the state of Colorado, voluntary sterilization, contraception approved by the FDA, including coverage without a prescription for all over-the-counter drugs. Requires companies to cover the contraceptive drug of the woman’s (and her doctor’s) choice. Bans copays, deductibles, coinsurance or any other cost-sharing mechanism for all of these services and drugs, unless it would disqualify a high-deductible plan from eligibility for a health savings account. Has a religious employer exception for abortion procedures only if the carrier notifies all employees of the exempted employer in writing of the procedures the employer is refusing to cover. Religious exemptions are only available to organizations where religion is the purpose of the entity and it primarily employs and serves people who share the same religious beliefs. Directs the state’s Medicaid program to implement all of the same coverage requirements to eligible individuals except for abortion payments (illegal under federal law) and expands postpartum Medicaid care from 60 days to 180 days. Also bans discrimination based on race, color, national origin, sex, sexual orientation, gender identity, religion, age, or disability in terms of benefits, coverage, or payments required.

KILLED IN HOUSE COMMITTEE

Pros

Women’s reproductive health is the private business of each individual woman and she is the one who gets to decide what legally available medical decisions to make about her body, not her boss and not the government. For true religious organizations, that are actually doing religious work, there is an exception build into the law. But beyond that, it is a critically important societal decision with enormous and far-reaching consequences. Adequate and affordable reproductive health care helps ensure healthy births, healthy babies, and healthy mothers. Women who lack adequate prenatal care are three to four times more likely to die of pregnancy related complications and maternal mortality rates in Colorado are rising, yes rising in the 21^st century. In addition, preventing unwanted pregnancies has enormous societal benefits. Unwanted pregnancies lead to abortions, delayed prenatal care, increased risk of physical violence, and more post-birth negative outcomes as a family or just a woman on her own, has to handle the enormous emotional, physical, and monetary strains a child can bring. All of this care can be expensive, so it won’t matter if we have quality reproductive care available if it remains out of reach for too many women.

Cons

This bill discriminates against sincerely held religious beliefs by making a religious exemption only possible for very few entities outside of churches or missions. Even these exempt entities would still have to offer contraception coverage which goes against their sincerely held religious beliefs. Religious hospitals, schools, charities, and many other organizations are excluded by the bill’s definition and would have to offer health care that goes against their deeply held religious beliefs, going against the spirit of federal law, state law, and years of 1^st amendment traditions. Or they have to not offer any health care at all to their employees and potentially, if they are large enough, run afoul of the federal Affordable Care Act requirements. On the financial side, it also goes against our generally accepted practice of trying to patients to use less-expensive drugs when a viable alternative is available that works just as well for the patient as the expensive drug.