Federal judge allows for coverage of fertility awareness methods under health insurance

couple fertility awareness NFP Chinnapong / Shutterstock

A federal court this week issued an order restoring fertility awareness-based family planning methods, a form of natural family planning, to health insurance plans nationwide under the Affordable Care Act. 

The U.S. Department of Health and Human Services (HHS) had in December 2021, without explanation, removed “fertility awareness-based methods” (FABM) from the list of “preventative care and screenings” covered under the Affordable Care Act. The language had been in place since 2016; the removal had been set to go into effect this month.

Attorneys with the faith-based legal organization Alliance Defending Freedom (ADF) filed a lawsuit in May on behalf of Cami Jo Tice-Harouff, a Texas nurse practitioner, and her patients against HHS and its leadership. Tice-Harouff, who holds a Ph.D. in nursing practice and is a member of the Catholic Medical Association (CMA), instructs patients in FABM, the lawsuit said, and is reimbursed through insurance about $350-$400 each session. While based in Longview, Texas, she is licensed and practices in several states. 

The Dec. 6 order of the U.S. District Court for the Eastern District of Texas, Tyler Division, restores language to requirements issued under the Affordable Care Act that “instruction in fertility awareness-based methods … should be provided for women desiring an alternative method” to hormonal birth control. The same court had in August issued an order temporarily blocking the Biden administration’s action.

“The Biden administration can’t illegally impose its own preferred contraceptive methods on all women without even allowing them to express their views. When it comes to family planning, countless women depend on fertility awareness-based methods to help them raise families in a manner consistent with their unique needs,” said ADF Senior Counsel Julie Marie Blake. 

Fertility awareness methods enable women to track their fertile cycles by charting one or more biomarkers, such as basal body temperature, cervical mucus, and hormone levels. Among other things, couples can use this information, in line with Catholic Church teaching, to avoid or achieve pregnancy.

In a press release about the lawsuit, CMA stressed that “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.”

Grace Emily Stark, the editor of Natural Womanhood, a nonprofit organization dedicated to promoting fertility awareness and fertility charting as essential tools for women’s health, told CNA in June that FABM is important for couples using it for family-planning purposes but also for women to use it for infertility diagnosis and cycle-issue diagnosis and treatment. 

Stark explained that, unlike outdated methods such as the rhythm method, modern methods provide high rates of accuracy by relying on “real-time data” by tracking biomarkers that indicate when a woman can and cannot become pregnant.

“The most important thing to hammer home is that these methods — if you really care about giving women choice when it comes to family planning and when it comes to their reproductive health — why would you be taking off the table coverage for methods that are as effective or more effective than what you’re already covering?” she asked.

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