HHS: All Methods of Birth Control Must Be Covered

Following reports of coverage violations, the Obama administration clarifies ACA coverage requirements.

Third-generation contraceptive pills are displayed on January 2, 2013 in Lille, in northern France.
National Journal
May 11, 2015, 11:35 a.m.

The Obama ad­min­is­tra­tion on Monday cla­ri­fied birth con­trol cov­er­age man­dates un­der the Af­ford­able Care Act, say­ing that at least one form of all 18 FDA-ap­proved meth­ods of birth con­trol must be covered without cost-shar­ing.

The guid­ance re­spon­ded to con­cerns that the con­tra­cept­ive cov­er­age re­quire­ments were un­clear or not be­ing ful­filled. The Af­ford­able Care Act re­quires that pre­vent­ive ser­vices, such as well-wo­man vis­its and con­tra­cep­tion, be covered without out-of-pock­et ex­penses.

Al­though evid­ence of cov­er­age non­com­pli­ance had been largely an­ec­dot­al, two re­ports re­leased with­in the past month by the Kais­er Fam­ily Found­a­tion and the Na­tion­al Wo­men’s Law Cen­ter de­tailed birth con­trol cov­er­age vi­ol­a­tions.

The Kais­er re­port found that al­though con­tra­cept­ive cov­er­age in­creased un­der Obama­care, most private in­surers still did not cov­er all forms without some kind of cost-shar­ing or lim­it­a­tions. It found that some con­tra­cept­ive meth­ods were less likely to be covered than oth­ers, in­clud­ing the patch, im­plants, and the va­gin­al ring.

“The Af­ford­able Care Act was a ma­jor step for­ward in help­ing wo­men get the health care ser­vices they need to stay healthy. Tens of mil­lions of wo­men are eli­gible to re­ceive cov­er­age of re­com­men­ded pre­vent­ive ser­vices without hav­ing to pay a co-pay or de­duct­ible, in­clud­ing con­tra­cep­tion,” Health and Hu­man Ser­vices Sec­ret­ary Sylvia Math­ews Bur­well said. “Today, we are cla­ri­fy­ing these cov­er­age re­quire­ments.”

The Na­tion­al Wo­men’s Law Cen­ter re­port found that, among in­surers not com­ply­ing with the ACA’s birth con­trol be­ne­fit, in­sur­ance com­pan­ies were not cov­er­ing all FDA-ap­proved birth con­trol meth­ods, were lim­it­ing cov­er­age to gen­er­ic birth con­trol, or wer­en’t cov­er­ing ser­vices as­so­ci­ated with birth con­trol (such as coun­sel­ing or fol­low-up vis­its) without out-of-pock­et costs.

“It’s go­ing to help wo­men so much. We’ve heard from so many wo­men who aren’t get­ting cov­er­age for the ring or the patch,” said Gretchen Borchelt, vice pres­id­ent for health and re­pro­duct­ive rights at NWLC, of the HHS guid­ance. “This makes it ab­so­lutely clear they have to cov­er the meth­od that’s right for the wo­men.”

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