Insurers Cover Some Contraceptives, But Not All

Despite an Obamacare mandate, most private health insurance plans do not cover all forms of contraceptive services and supplies.

Obamacare supporters celebrating after the Supreme Court ruling on the Affordable Healthcare Act in June 2012 in front of the U.S. Supreme Court.
National Journal
April 16, 2015, 11:09 a.m.

Con­tra­cept­ive cov­er­age has in­creased un­der an Obama­care man­date, but most private health in­surers still do not cov­er all forms of con­tra­cept­ives without some form of cost-shar­ing or lim­it­a­tions, ac­cord­ing to a re­port from the Kais­er Fam­ily Found­a­tion.

Be­gin­ning in Au­gust 2013, the Af­ford­able Care Act re­quired most private plans to provide cov­er­age for wo­men’s health care without cost-shar­ing, in­clud­ing all FDA-ap­proved con­tra­cept­ive ser­vices and sup­plies. Al­though there have been an­ec­dot­al re­ports of wo­men be­ing un­able to se­cure cov­er­age, the Kais­er re­port was the first time that plan cov­er­age of con­tra­cept­ives has been stud­ied.

“It really is a game changer for wo­men. But we also hear from wo­men every day who are hav­ing trouble get­ting the be­ne­fit,” said Gretchen Borchelt, a vice pres­id­ent at the Na­tion­al Wo­men’s Law Cen­ter.

The re­port col­lec­ted in­form­a­tion from 20 car­ri­ers in five states, al­though the car­ri­ers were na­tion­al and most likely have the same plans across loc­a­tions and both with­in and out­side of ex­changes.

“Be­cause con­tra­cep­tion is so com­mon, most of the plans make cov­er­age de­cisions across all their lines of cov­er­age,” said Alina Sal­gan­icoff, the vice pres­id­ent and dir­ect­or of wo­men’s health policy at Kais­er.

Some con­tra­cept­ive meth­ods - par­tic­u­larly the va­gin­al ring, the patch and im­plants - are lim­ited by plans more of­ten than oth­ers, ac­cord­ing to the re­port. It can also be dif­fi­cult for wo­men to de­term­ine which con­tra­cept­ive forms are covered un­der their plan.

Des­pite na­tion­al at­ten­tion to re­li­gious ac­com­mod­a­tions, in­surers re­por­ted they have re­ceived few re­quests for an ac­com­mod­a­tion from em­ploy­ers with an ob­jec­tion to con­tra­cept­ive cov­er­age be­cause of their re­li­gious af­fil­i­ation.

Borchelt said that reg­u­lat­ors need to step up en­force­ment of the law and to of­fer fur­ther guid­ance as to its im­ple­ment­a­tion.

“These are vi­ol­a­tions of the law. These plans are vi­ol­at­ing the Af­ford­able Care Act. They need to come in­to com­pli­ance,” she said.

In re­sponse to the re­port, HHS emailed a state­ment say­ing that it “strongly sup­ports en­sur­ing that wo­men can ac­cess con­tra­cept­ive ser­vices.”

“We ap­pre­ci­ate the im­port­ance of this is­sue and plan to re­lease more guid­ance soon,” spokes­wo­man Katie Hill wrote.

This story has been up­dated.

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