More benefits coming for men?

States push for cost-free vasectomies in mandate

ALBANY, N.Y. — Call it contraception equality.

Vasectomies, which are not covered under President Barack Obama’s health care law, are increasingly being included in state measures that would require insurers to provide cost-free coverage of birth control.

Backers of laws and proposals in such states as Illinois, Vermont, Maryland and most recently New York say that if women can get tubal ligations with no out-ofpocket costs, men should be able to get their surgical sterilization covered costfree as well. Such state measures are seen as a key backup if the federal mandate is repealed.

The Association of Reproductive Health Professionals says excluding vasectomies from the contraceptive coverage mandate doesn’t make sense financially and reflects the view that family planning is a “woman’s issue.”

Such changes could be significant because, according to studies by the Guttmacher Institute, which looks at reproductive health issues, nearly a quarter of women using birth control would prefer male-only methods of condoms and vasectomies. Neither method had been included among the cost-free options in Obamacare.

Most state Medicaid programs provide free access to all birth control methods, including those for men.

But the only way to add vasectomies to the no-copay contraceptive coverage mandated for private insurance plans under Obamacare is to expand the law, which is unlikely to happen given current repeal efforts.

“That’s why some states have been looking at this,” said Adam Sonfield, a Guttmacher policy analyst.

Over the past two years, California, Illinois, Vermont and Maryland have passed laws requiring private insurance companies to cover contraception without out-ofpocket costs, and all but California include vasectomies.

The health insurance industry opposes the mandate.

“Our objection isn’t to including vasectomy, but mandating that it be free of charge,” said Leslie Moran, senior vice president of the New York Health Plan Association. “At a time when we are looking to ensure affordability, we shouldn’t be looking to add new requirements and new costs that would be borne by all premium payers.”

A vasectomy, which blocks sperm from getting to the seminal fluid, is an outpatient procedure that takes 20 minutes or less and is done with a local anesthetic.

A no-scalpel option uses a tiny puncture to reach both sperm tubes and tie them off. It costs up to $1,000, according to Planned Parenthood.