Pelosi: ‘I Don’t Subscribe to Your Characterization’ that HHS Rule Requires Free Sterilizations for Teens

By Amanda Swysgood | August 3, 2012 | 6:56pm EDT

( – House Minority Leader Nancy Pelosi (D-Calif.) said she doesn't “subscribe” to the “characterization” that the Health and Human Services Department (HHS) mandate requires that health plans cover free sterilization for teenage girls.

The regulation is part of a “preventative services” mandate issued by HHS Secretary Kathleen Sebelius, which took effect Aug. 1. asked Pelosi at her weekly news conference on July 26: “Do you support the regulation taking effect August 1 that requires health plans to offer free sterilizations to teenage girls?”

“I don’t subscribe to your characterization of it,” the Democratic Leader replied, moving on to another question.

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Over a period of several days, sought further clarification from Pelosi’s press office. Multiple E-mails and phone calls went to Pelosi Press Secretary Drew Hammill and Deputy Press Secretary Nadeam Elshami. posed these questions:

1) "Does Leader Pelosi contest that insofar as the regulation applies to 'all women with reproductive capacity' it applies to teenage girls who have reproductive capacity?"

2) "Does she support requiring health-care plans to offer cost-sharing-free sterilizations to teenage girls who have reproductive capacity?"

3) "Would she like to see the regulation changed so it only applies to women who have reproductive capacity and have attained the age of 21?"

No response was given.

The HHS regulation, which took effect 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.

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.

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

The IOM further 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.”

According to the National Institutes of Health, 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 titled, “Preventing Unintended Pregnancy and Promoting Healthy Birth Spacing,” where it states, “Unintended pregnancy is highly prevalent in the United States.”PREVENTIVE SERVICES-IOM REPORT-1.pdf

“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.”

Pelosi said of the Supreme Court decision upholding the Affordable Care Act: “This decision is a victory for the American people. With this ruling, Americans will benefit from critical patient protections, lower costs for the middle class, more coverage for families, and greater accountability for the insurance industry.”

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