A federal court has ordered the Biden administration to restore “fertility awareness” language to family planning guidelines used to determine benefits in Obamacare and most health insurance plans.
Cami Jo Tice-Harouff, DNP, a licensed nurse practitioner, filed suit against the Health Resources and Services Administration, the agency of the U.S. Department of Health and Human Services (HHS) that removed the language. Tice-Harouff argued the move was illegal, arbitrary, and limited the instruction on fertility-based family planning she typically provides her patients.
After the language was removed, the Catholic Medical Association (CMA), of which Tice-Harouff is a member, released “public comments,” calling for the language to be restored without change.
Removed ‘Fertility Awareness’ Language
Under the Affordable Care Act, insurance plans “must cover contraceptive methods and counseling for all women, as prescribed by a health care provider,” states the HealthCare.gov website.
In 2016, the requirement was expanded to include “instruction in fertility awareness-based methods” as contraception.
The Biden administration removed the ‘fertility awareness’ language from the Women’s Preventive Services (WPS) Guidelines in 2021, in a move that affected 60 million women. There was no notice-and-comment period for the change, as required under the Administrative Procedure Act (APA).
Judge Jeremy D. Kernodle, of the U.S. District Court for the Eastern District of Texas, Tyler Division, ordered the Biden administration to restore the previous language, on December 6.
The restored WPS Guidelines now state “Additionally, instruction in fertility awareness-based methods, including the lactation amenorrhea method, although less effective, should be provided for women desiring an alternative method.”
‘Back-Room Government Decisions’
The violation of the APA is typical of the implementation of the Affordable Care Act, says Matt Bowman, a senior counsel at the Alliance Defending Freedom, a public interest law firm, which represented Tice-Harouff.
“Under Presidents Obama and Biden, HHS has long implemented Obamacare without respect for basic values or the public comment process,” said Bowman. “We are grateful that the court restored to tens of millions of women the right to access fertility awareness-based methods that help them raise families in a manner consistent with their unique needs.”
Kernodle’s order is “a win for women and couples,” that restores her ability to continue instructing patients in multiple evidenced-based family planning and fertility awareness methods and to be a ‘preferred provider’ to her patients, says Tice-Harouff.
“Women should never have to fear losing their doctor and insurance coverage for fertility awareness instruction as a result of back-room government decisions,” Tice-Harouff said. “I applaud the court’s order for restoring fertility awareness-based methods of family planning to health insurance plans.”
Family Planning Alternative
There are several advantages to Fertility-Awareness Based Methods (FABM), according to the CMA.
“Women choose FABM for a variety of reasons, including the desire to avoid the use of hormones and devices, to avoid the ill side effects of other forms of birth control, and to understand one’s natural body processes consistent with religious preferences,” states the CMA’s comments.
CMA also stated FABM can be used to avoid or achieve pregnancy and that “typical use failure” can be as low as 2 percent.
Ashley Bateman (bateman.ae@googlemail.com) writes from Virginia.
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