Federal health officials put insurers on notice over contraceptive coverage
Federal health officials made a statement underscoring the fact that private health insurers are required to cover contraception in the United States.
The statement comes in wake of the Supreme Court’s decision to overturn Roe v. Wade, which guaranteed the right to access abortion care in the U.S. for the last nearly 50 years. The court’s June 24 decision immediately set off a wave of abortion care restrictions and bans in many states, impacting healthcare providers in still unknown ways. Additionally, the high court made clear in its majority opinion, written by Justice Alito, that it would like to reconsider cases that legalized access to contraceptive care.
As a result of the decision, Secretaries Xavier Becerra, Marty Walsh, and Janet L. Yellen of the U.S. Departments of Health & Human Services (HHS), Labor and Treasury (Departments), respectively, issued a letter to private health insurers about their continued requirements for contraceptive coverage. Specifically, insurers are obligated to cover contraceptives with no charge to patients under the Affordable Care Act (ACA). The guarantee of free birth control and contraceptive counseling for covered individuals and dependents is required in all 50 states.
"The Biden-Harris Administration is committed to strengthening access to care and coverage. We are calling on the industry to remove impermissible barriers and ensure individuals have access to the contraceptive coverage they need, as required under the law," the officials wrote in the letter. "It is more important than ever to ensure access to contraceptive coverage with no out-of-pocket costs under the Affordable Care Act."
The officials also noted that there are some reports that insurers are not meeting this requirement appropriately under the law. The letter was intended to put the industry “on notice” about its obligations.
"Preventive reproductive healthcare is critical healthcare,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “The contraceptive coverage requirements under the Affordable Care Act have been in place for over a decade, and we expect plans and issuers to meet these obligations. The Biden-Harris Administration is committed to ensuring access to health care for all, including access to contraceptive coverage at no cost."
The requirements mandate that plans and issuers are required to cover, at no cost, at least one form of contraception within each of the contraceptive categories identified by the U.S. Food and Drug Administration (FDA), including instances when an FDA-approved, -cleared, or -granted contraceptive product that is recommended by the individual's medical provider does not fall within one of the identified categories, HHS clarified. Further, plans and insurers must have an easily accessible, transparent, and sufficiently expedient exceptions process in place to ensure patients can receive contraceptives with no cost sharing.
Both HHS and the Department of Labor are concerned about reports of insurers and plans not following through on these obligations with respect to contraceptive coverage, and expect insurers and plans to meet the standards under the ACA.
Amy joined TriMed Media as a Senior Writer for HealthExec after covering home care for three years. When not writing about all things healthcare, she fulfills her lifelong dream of becoming a pirate by sailing in regattas and enjoying rum. Fun fact: she sailed 333 miles across Lake Michigan in the Chicago Yacht Club "Race to Mackinac."