Preventive care moves to the head of the class in the health care overhaul law, because starting this fall, new health plans will have to begin providing certain preventive medical services free of charge.

If women’s health advocates get their way, prescription contraceptives will be included.

They say that preventing some of the estimated 3 million unintended pregnancies each year has clear health benefits for both women and children, and it saves money.

Unwanted pregnancies cost the health care system $5 billion in 2002, according to a study published in the journal Contraception in 2007 by Princeton's James Trussell.

But even if birth control makes the list, that doesn't mean all methods would be covered. “I’d be thrilled if condoms were free everywhere,” says Cecile Richards, president of Planned Parenthood Federation of America.

Health plans generally only cover prescription contraception, so over-the-counter methods like condoms wouldn’t make the cut.

Neither would emergency contraception, which is typically also sold over the counter to adult women.

But there may be a new contraceptive available soon that might make the already controversial issue of providing free prescription contraception more controversial.

An FDA advisory panel recently voted to approve a new pill called “Ella” that prevents pregnancy for five days after unprotected intercourse. Unlike other so-called morning-after pills that generally offer protection for three days, Ella would be sold by prescription only.

But FDA still has to approve it, and there is some pretty vocal opposition.

Advocates on both sides disagree over what the pill actually does: Supporters say it prevents ovulation, while opponents claim it prevents the fertilized egg from implanting in the uterus, which some consider equivalent to abortion. This debate won’t be settled anytime soon.

But for now, “The FDA’s clear position is that Ella is a form of birth control,” says Richards.

The Health Resources and Services Administration has the final say. They're the agency charged with recommending what's covered in the new law, but don't hold your breath. It may be months away.

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