Two days ago, the Institute of Medicine (IOM) released a report identifying important preventive services for women’s health and well-being. The report provides recommendations to the U.S. Department of Health and Human Services (HHS) as it develops comprehensive guidelines under the Affordable Care Act (ACA) of 2010. Under the ACA, health services designated as “preventive” will be covered by health plans without requiring a co-payment.

The IOM wisely identified contraception as a preventive service for women. The adoption of this recommendation by HHS would be a win for millions of women who are currently unable to afford birth control. It would also be a win for U.S. taxpayers.

Research shows that medical costs for births resulting from unplanned pregnancies are about twice as likely to be publicly financed – that is, paid for through government programs like Medicaid and CHIP that are funded with taxpayer dollars – than medical costs for intended births. A recent Guttmacher Institute study estimated that 64 percent of births resulting from unintended pregnancies in 2006 were paid for by Medicaid and CHIP (compared with 35 percent of births from intended pregnancies), and state and local governments spent a total of $11.1 billion to cover the costs of prenatal care, labor and delivery, post-partum care, and early infant care resulting from these unintended births. And that estimate does not account for potential longer-term costs, such as continued Medicaid/CHIP coverage or other government assistance.

But expanding access to birth control has the potential to substantially reduce these costs. Studies show that publicly funded family planning services already save the public sector between $4.3 billion and $5.1 billion annually by preventing unplanned pregnancies, and researchers at the Brookings Institution recently estimated that preventing all unplanned pregnancies would save taxpayers an additional $5.6 billion per year. This is a tremendous amount of savings, equal to more than three-quarters the value of federal funding for WIC ($7.25 billion) or Head Start and Early Head Start ($7.23 billion).

Access to contraception without co-pays, then, would not only improve the health and well-being of millions of women and promote optimal birth outcomes for their children: it also would provide substantial savings to U.S. taxpayers. Especially in light of the country’s current fiscal climate, this potential savings would make the adoption of the IOM’s recommendation truly a win-win.


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