Michigan Senate Bill 1006 requires that Maternity Wards of all religious affiliations stock and provide contraceptives to desiring patients.

A hospital that operates a maternity unit shall ensure that an individual who is giving birth in the hospital has the option, if not medically contraindicated, of having an intrauterine device implanted after delivery and before the individual is discharged. A hospital shall ensure that a sufficient number of intrauterine devices are in stock and available at the hospital to meet the requirements of this section.

https://www.legislature.mi.gov/documents/2023-2024/billintroduced/Senate/pdf/2024-SIB-1006.pdf

The short Bill, which was supported in its Health Policy committee meeting this past Thursday, makes no exemption for Catholic Hospitals which might have a religious dispute with furnishing contraceptives to patients. This may prove to create a dispute between the Legislature and religiously affiliated Healthcare Systems.

Meeting Notes for Thursday's committee: https://committees.senate.michigan.gov/committees/ViewDocument/?apn=2023_2024_session%2Fcommittee%2Fsenate%2Fstanding%2Fhealth_policy%2Fmeetings%2F2024-09-26-1%2Fdocuments%2Ftestimony%2FAmy%20Zaagman%20MCMCH%20Support%20SBs%20973%20974%20987%20988%201006.pdf

Lest we forget the breast cancer implications here, the risk was reiterated last week.

MedPage reports JAMA's publication of a recent Danish study.

Methodology is clipped for length, but worth reading.

https://www.medpagetoday.com/hematologyoncology/breastcancer/112451

Hormonal IUDs Linked to Increased Breast Cancer Risk

— Absolute risk remains low, however

by Charles Bankhead    |    October 17, 2024

Women younger than 50 who used a levonorgestrel-releasing intrauterine device (IUD) had a significantly higher risk of breast cancer as compared with women who did not use hormonal contraceptives, a Danish registry study showed.

During follow-up of almost 7 years, hormone-releasing IUD use conferred a 40% higher risk of breast cancer. The data showed a trend toward increasing risk with duration of IUD use, reaching 80% among women who reported using the devices for 10-15 years.

The differences translated into excess breast cancer diagnoses that ranged from 14 to 71 per 10,000 users, although a trend analysis proved to be nonsignificant, reported Lina Steinrud Mørch, PhD, of the Danish Cancer Institute in Copenhagen, and co-authors in JAMA.

"Given the increase in LNG-IUS [levonorgestrel intrauterine systems] among females at an age with some risk for breast cancer, and its likely long-term use, information about breast cancer risk should accompany discussions about benefits and risks," the authors stated. In a prior study, "the HR [hazard ratio] with short-term LNG-IUS use was similar to that of contraceptive pills (1.2, 95% CI 1.1-1.3)."

But that earlier research could not address the duration of continuous use, and prior studies have not adequately accounted for use of other types of hormonal contraceptives.

The new results add to existing evidence suggesting an association between hormonal contraception and breast cancer, and are consistent with a recent study showing a 29% greater relative risk for breast cancer among BRCA1 carriers who used any type of hormonal contraceptive.

To examine breast cancer risk by duration of LNG-IUS use, Mørch and colleagues queried Danish national healthcare registries to identify first-time users of LNG-IUS, ages 15-49, during 2000-2019. Users of other hormonal contraceptives within the previous 5 years were excluded.

The search identified 78,595 new users of LNG-IUS who were matched to 78,595 non-users of hormonal contraceptives. The study population had a mean age of 38. Mean duration of follow-up was 6.8 years for the entire population, including 5.9 years for the LNG-IUS users and 7.7 years for the non-users.

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It seems Gov. Whitmer was not content with the legislature's pace on these bills.

Yesterday, several news sources broke the news of her executive order mandating insurance cover birth control pills, even the over-the-counter kinds.

Quoting Fox 17 News here. MLive's story is behind paywall.

https://www.fox17online.com/news/local-news/michigan/michigan-to-roll-out-free-contraceptives-program-next-month

Michigan to roll out free contraceptives program next month

The state of Michigan is launching a new program in November that will guarantee free access to contraception.

 

 

Posted 6:49 PM, Oct 23, 2024

LANSING, Mich. — The state of Michigan is launching a new program in November that will guarantee free access to contraception.

The “Take Control of Your Birth Control” program allows participating community partners and federally qualified health centers the ability to distribute free condoms, birth control and emergency contraception to Michiganders.

Recipients will also be given information that will enable them to make informed decisions on their reproductive health.

“We always want people to know what health resources that are available, especially if health options are available for free or low cost. I think it's our duty to really educate them,” says Dr. Natasha Bagdasarian, chief medical executive at the Michigan Department of Health and Human Services. “It's our role to really make sure that people have the best information possible so that they can make decisions about their health and their bodies that work for them.”

The program lasts through November.

The state expects to publish a full list of participating organizations — and an interactive map of their locations — on its website before next Friday.

Marquette WLUC's Colin Jackson included a detail not reported elsewhere:

"Contraceptive items will be distributed until supplies run out."

Fascinating thought.

One wonders how he reached it. Because it's spelled out in the EO?

Because everyone knows this market challenge will cause shortages?

Or - ??

Back in August, Michigan Public's Tracy Samilton reported some of the back room dealing on these bills.

Importantly, mandating insurance coverage for over the counter birth control negates competitive price drops.

Expect health insurance rates to rise, since this also returns cost burden to insurance premiums and taxpayers.

https://www.michiganpublic.org/health/2024-08-02/new-state-senate-bills-would-expand-insurance-coverage-of-birth-control

New state Senate bills would expand insurance coverage of birth control

August 2, 2024

Bills introduced this week (SB 973, SB 974) in the state Senate would expand what kind of birth control health insurance plans in Michigan would be required to cover.

Federal law requires Medicaid and nearly all private health insurance plans to cover many kinds of contraceptive drugs requiring a prescription, without copays -- but not over the counter types of birth control like the recently approved Opill, or the emergency contraception drug Plan B.

New bills introduced in the state Senate would require Michigan health insurance plans to cover these over-the-counter birth control drugs as well.

The Michigan Association of Health Plans says it supports maintaining access to contraceptive drugs — while it plans to work with the bills' sponsors to better understand the intent of the bills, and evaluate their impact on health insurance cost and affordability.

Meanwhile, these bills (and more) are still on this committee's action list. They might be worth a conversation next time you see a legislator.

One day before Gov. Whitmer's announced free BCP, the Biden Administration proposed a federal rule to do the same thing. Coordinated? Or one-upmanship?

In Michigan, of course, taxpayers actually pick up the tab. In this case, funds from MDHHS's family planning budget, which the legislature expanded this year by 5.6M.

In Washington's plan, we'll still be picking up the tab, just with a larger bureaucracy. On the plus side, the feds operate under rulemaking procedures, and the public comment period is open. Anyone concerned about this can give their two cents.

Morning Brew reported the DC side of the story.

https://www.morningbrew.com/daily/stories/2024/10/22/white-house-wants-to-make-over-the-counter-birth-control-free

White House wants to make over-the-counter birth control free

Insurers might be required to offer full coverage of OTC birth control pill and other contraceptives.

By Sam Klebanov   |    October 22, 2024

The Biden administration unveiled a proposed rule yesterday that would require private insurers to pick up the tab for all prescriptionless birth control.

Insurance companies are already mandated to offer 100% coverage of some prescription contraceptives (thanks, Obamacare), but the 2010 law doesn’t address over-the-counter birth control pills, which only recently arrived in the US.

Removing barriers to birth control

The FDA approved an OTC birth control pill, Opill, for the first time last year. But Opill sells for $19.99 per month, so many women with private insurance looking for free access to birth control may not be able to get it. The same often goes for prescribed contraceptives: Reproductive rights activists say that some of the latest birth control methods that are associated with fewer side effects aren’t 100% covered by many insurance plans.

Biden’s rule aims to fix this by also requiring insurers to fully cover a greater variety of IUDs and other products that may appear in a sex-ed curriculum.

Looking ahead: The birth control access push comes just two weeks before the presidential election, in which family planning has been a major flashpoint. The next White House occupant will get to decide whether the proposal goes into effect.

Finally, readers will recall that pharmacist-prescribing or "almost over the counter" was proposed for the same drug not long ago.

The third leg of the state-federal-industry tango showed up in a bill package posted here six months ago