A year from now, many insured women will no longer pay an additional cost for birth control, voluntary sterilization, breast-feeding support, HIV screening and a variety of other health services under new guidelines announced by the U.S. Department of Health and Human Services.

The provisions -- part of the sweeping federal Affordable Care Act -- will require new health insurance plans to cover preventive health services for women without requiring co-pays, co-insurance or a deductible.

Birth control advocates cheered the change, heralding it as a huge step forward in federal acknowledgement of contraception as a health service. "For the first time, contraception is being considered a very basic part of preventive women's health care," said Susan Yolen, vice president of public policy and advocacy for Planned Parenthood of Connecticut.

Until 1999, Yolen said, insurers in the state weren't required to cover birth control. Even with insurance coverage, some women still couldn't afford the co-pays for contraception. According to Planned Parenthood, co-pays for birth control pills can run from $15 to $50 a month and other methods -- such as IUDs -- can cost several hundred dollars.

"Without those co-pays, women might not balk at using a method," Yolen said. "Women can use birth control without having to make a decision every month about whether to pay (the co-pays) or to pay for something else they need."

However, birth control opponents are upset by the provisions, even with an amendment that allows religious institutions that offer insurance to employees the choice of whether to cover contraception. Michael C. Culhane, executive director of the Connecticut Catholic Conference, said the exemption is too narrow, and wouldn't protect most Catholic agencies. Also, the mandate doesn't allow health care providers to refrain from providing a service for reasons of conscience.

"If somebody wants to perform a certain procedure, that's fine," Culhane said. But, he added, those who don't wish to provide a procedure or service should be allowed to make that choice.

"These guidelines don't address the conscience protection issue at all," he said.

Other services covered through the guidelines include an annual "well woman" physician visit, gestational diabetes screening, breast-feeding supplies and support, and domestic violence screening and counseling.

Ludwig Spinelli, chief executive officer of Optimus Health Care in Bridgeport, said the provisions could ensure that more women take better care of themselves. Optimus is a community health center that provides low-cost services to the uninsured, as well as those with insurance that doesn't cover all their needs.

"This is a great thing for preventive care," he said. "Hopefully, this will encourage people to live a healthier lifestyle."

Dr. William Cusick, chairman of obstetrics and gynecology at St. Vincent's Medical Center in Bridgeport, also thinks the guidelines will benefit some women, particularly those who can't afford birth control or breast-feeding support services. But he said it remains to be seen how the plan will shake out. One likely consequence, Cusick said, is higher health premiums as a result of doing away with co-pays for certain services.

"It all begs the question -- who is going to pay for this?" Cusick said. "These costs aren't just going away."