Rep. Schakowsky ‘Unaware’ Obamacare Reg Requires Offering Free Sterilizations to Teens

Elizabeth Harrington | July 25, 2012 | 6:35pm EDT
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( - Rep. Jan Schakowsky (D.-Ill.) said she was “unaware” that the preventive services regulation that Health and Human Services Secretary Kathleen Sebelius has issued under the Obamacare law requires health care plans to offer free sterilizations to girls as young as their teens.

However, back in March, Schakowsky did acknowledge that the mandate offers sterilizations free of charge to college-age women, stressing at that time that the HHS rules were designed to “protect the health of women, women of all ages.”

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The HHS regulation, which takes effect on Aug. 1, requires nearly all health care plans in the United States to provide, without cost sharing, “all Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity,” which means all women who have begun ovulating, including teenagers.

At the Capitol on Wednesday, asked Rep. Schakowsky, “The HHS preventive services mandate requires all health plans to offer free sterilizations, including to girls in their teens. Do you support the mandate as it applies to teens?”

At that point, Rep. Schakowsky started to walk away without answering but, while walking, she said, “I don’t--I’m unaware that it says that sterilization including teens is in that. I’ll check that out.”

“I will check that out,” she said. then followed up, “It says all women of ‘reproductive capacity,’ and it defines it as from menarche to menopause.”

“I’ll check that out,” she said.

HHS Secretary Sebelius proposed the regulation last August as part of the implementation of the Affordable Care Act, popularly known as Obamacare. It was finalized in February 2012.

PResident Barack Obama and Health and Human Services Secretary Kathleen Sebelius. (AP Photo)

The regulation was recommended by a federally funded committee at the Institute of Medicine (a part of the National Academy of Sciences), which explained in making its recommendation that “women with reproductive capacity” meant women “from the time of menarche to menopause.” Menarche is a young woman’s first menstrual cycle.

It stated: “Unintended pregnancy is defined as a pregnancy that is either unwanted or mistimed at the time of conception … and affects women with reproductive capacity, that is, from the time of menarche to menopause.”

The National Institutes of Health says that young women usually start to menstruate “around age 12.” Thus the HHS-mandated insurance coverage providing sterilizations without cost-sharing would apply to girls as young as 12.

The IOM report’s recommendation for the HHS mandate comes from an 8-page section entitled, “Preventing Unintended Pregnancy and Promoting Healthy Birth Spacing,” where it states, “Unintended pregnancy is highly prevalent in the United States.”

“Although 1 in 20 American women has an unintended pregnancy each year, unintended pregnancy is more likely among women who are aged 18 to 24 years and unmarried, who have a low income, who are not high school graduates, and who are members of a racial or ethnic minority group,” the report reads.

The section concludes: “The committee recommends for consideration as a preventive service for women: the full range of Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling for women with reproductive capacity.”

Rep. Jan Schakowsky (D-Ill.) (AP Photo)

Schakowsky, a member of the House Energy and Commerce Committee, which has oversight over the Affordable Care Act, had said the HHS mandate was designed to “protect the health of women, women of all ages.”

The Obama Administration announced in March that the preventive services mandate would also apply to college and university health plans, “to ensure students enrolled in these plans benefit from important consumer protections in the Affordable Care Act,” an HHS Fact Sheet stated. previously asked Schakowsky if she supported the regulation that requires health insurance companies to provide free sterilizations to college-age women who want them, during a conference call on March 19.

“This isn’t about promoting sterilization,” she said.  “No one--there aren’t college girls lining up to become sterilized because they feel like it. And we’re talking about medical procedures.”

Schakowsky added that “there may be situations where for medical reasons and in consultation with the doctor that sterilization procedures are warranted for the health of a young woman.”

“Contraception and related procedures, contraception was declared one of the top 10 preventive health services of the 20th century by the Centers for Disease Control," she said.

“And the reason for these regulations is to protect the health of women, women of all ages, so that they can afford to get the preventive care that they need.”

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