Yesterday, the Institute of Medicine Committee on Preventive Services for Women held its third public meeting. This independent, expert panel is changed with developing recommendations about which preventive services for women, in addition to those the Affordable Care Act already requires, should be covered in all new insurance plans and provided without co-payments or other cost-sharing.
During yesterday’s meeting, the Committee heard from several experts on a range of topics. Three experts, Dr. Doug Campos-Outcal from the American Academy of Family Physicians, Dr. Melissa Starkey from the American College of Physicians, and Dr. David Rind of UpToDate provided insightful comments about the process by which each organization develops evidence-based guidance to clinicians about the preventive services that should be provided in clinical settings. The purpose of this panel was to help inform Committee members about the range of processes used to develop clinical practice evidence and the merits of each, as well as how various expert body recommendations relate to and inform each other.
The Committee also heard from Professor Sara Rosenbaum of The George Washington University. Professor Rosenbaum described the ways insurance companies design their insurance plans and how coverage decisions are made, as well as the ways in which the Affordable Care Act will and will not affect insurance plan design and clinical practice decisions.
The final panel focused on specific preventive services for the Committee to consider. Dr. Gwen Keita of the American Psychological Association recommended that screenings for depression, suicide, and intimate partner violence be included in the panel’s final recommendations. Dr. Lauren Patton from the University of North Carolina School of Dentistry recommended a set of preventive interventions to improve women’s oral health. Finally, Dr. Melissa McDiarmid, Director of the Occupational Health Program at the University of Maryland School of Medicine spoke of the importance of including questions about a woman’s occupation and occupational history in all health histories to help inform and guide clinical recommendations.
There were few surprises during the opportunity for public comment. Representatives from the Family Research Council, the United States Conference of Catholic Bishops, the Christmas Medical Foundation, and a few others reiterated their opposition to any recommendation from the Committee that contraception be included among the services required to be covered in all new insurance plans and with no cost-sharing. There were others who urged the panel to cover contraceptives and several other women’s preventive health services. Among them, Susan Scanlon from the National Council of Women’s Organizations, who urged the panel to include contraceptives, HPV co-testing as part of routine cervical cancer screenings, and lactation counseling and supplies among its recommendations; Cindy Pearson of the National Women’s Health Network, who reiterated her support for the work of the Committee and thanked them for the speed with which they were working; and Deborah Arrindell from the American Social Health Association, who urged the Committee to recommend contraceptives, HPV co-testing, and screening for intimate partner violence. A representative from the American Diabetes Association also urged the Committee to review and reconsider U.S. Preventive Services Task Force recommendations on screening for Type II and gestational diabetes.
The Committee is expected to make its recommendations to the Department of Health and Human Services in May, and the Department is expected to make final decisions about whether and how to take up the Committee’s recommendations by August 1. Take a look at our resources for more information about the panel, our recommendations, and the overwhelming medical and public health consensus that contraception is basic preventive health care for women.