WASHINGTON U.S. health insurance companies must fully cover women's birth control and other preventive health care services under Obama administration rules released on Monday.
The mandate from the Health and Human Services Department represents a landmark decision in a decades-long debate on women's health issues that has pitted family planning groups against conservative organizations.
"Under the law, we're making it illegal to charge women more just because of their gender," HHS Secretary Kathleen Sebelius said on Monday.
The guidelines, a product of last year's healthcare overhaul, go into effect on Monday, and require insurers to do away with co-payments on coverage of preventive care services for women in all new plans beginning in August 2012.
The rules largely follow recommendations from a scientific advisory group released last month.
The U.S. Institute of Medicine (IOM) said in a July report that all government-approved birth control methods -- including the "morning-after pill," taken shortly after sexual intercourse to stop a pregnancy -- should be included in the U.S. list of preventive health services.
The newly required coverage also includes free screenings for gestational diabetes, testing for human papillomavirus in women over 30, counseling for HIV and sexually transmitted infections, and screening for domestic violence.
"Today is a historic victory for women's health and women across the country," said Cecile Richards, president of Planned Parenthood Federation of America. "The decision by HHS is monumental for millions of women."
Conservative groups balked at the decision to force private insurers to fully cover birth control. "HHS says the intent of its 'preventive services' mandate is to help 'stop health problems before they start,'" said Cardinal Daniel DiNardo, chairman of the pro-life activities committee at the U.S. Conference of Catholic Bishops. "But pregnancy is not a disease, and children are not a 'health problem.'"
In a nod to conservative groups, the HHS included an amendment to its final rules that would allow religious employees and institutions to choose whether to cover contraception services in their insurance.
For at least 50 years, religious objections to birth control have made the topic a hot-button social issue in the United States.
In 1965, a Supreme Court ruling ended an era when states could ban the use of contraceptives, arguing that such power violated "the right to marital privacy." In 1972, another case upheld unmarried couples' rights to the use of contraceptives.
Monday's rules mark another turn in the debate and could help put birth control in financial reach for some women.
Many of the bigger employers must include birth control among the services covered by their insurance, but require women to pay part of the price. The HHS guidelines would get rid of the co-pay.
"(Contraception) is not controversial in the lives of women... To an extent, this is not really new, but it's filling in the gaps," said Judy Waxman, vice president for health and reproductive rights at the National Women's Law Center, a non-profit pro-choice education center.
There is some question about how much impact the rule will have on coverage of the "morning-after pill."
The HHS rule requires coverage of contraceptives "as prescribed." Two most commonly used government-approved emergency contraceptives -- "Plan B" from Teva Pharmaceuticals and "Next Choice" from Watson Pharmaceuticals -- are sold over the counter. The only prescription emergency pill is Watson's "ella," approved in 2010.
"It's regulatory sleight of hand on the part of HHS," said Dr. Michele Curtis, an obstetrician and gynecologist at the University of Texas-Houston Medical School.
Still, some women said the government's mandate for full coverage of birth control is a welcome step.
"I'm not on it now, but I took it in my twenties, and it cost a small fortune back then," said 47-year-old Carole Murphy, who was shopping at a local CVS on Monday. "It's good to have the option if you need it."
To read the HHS guidelines, visit www.hrsa.gov/womensguidelines.
(Reporting by Alina Selyukh, Anna Yukhananov and Andrew Seaman. Editing by Maureen Bavdek and Robert MacMillan)