A new study confirms what women’s advocates have long suspected: Insurers still place lots of limits on covering birth control despite the healthcare law’s requirements to do so.
Kaiser Family Foundation researchers found many health plans don’t include all types of federally-approved contraception or they collect co-pays or require other steps before covering it, in a review of contraceptive coverage by 20 different plans in California, Georgia, Michigan, New Jersey and Texas.
As a part of the Affordable Care Act, insurers are required to cover all types of birth control approved by the Food and Drug Administration without charging a co-payment, according to rules issued by the Obama administration.
But researchers found that not all insurers are in full compliance, especially when it comes to intrauterine devices, implants, patches or rings.
For example, a majority of the plans cover the NuvaRing without any cost-sharing requirements, but five require a co-pay from customers and one plan doesn’t cover it at all, they found. Two insurers don’t cover contraceptive implants or patches at all, and three cover patches but only with cost-sharing.
Half the plans covered all three FDA-approved intrauterine devices with no cost-sharing, but one doesn’t cover ParaGard, which is the only nonhormonal IUD available. Most plans covered the emergency birth control pill known as Plan B, but just 11 covered without cost-sharing the similar Ella pill and one didn’t cover it at all.
Some plans said they either don’t cover contraceptive rings or patches because they have the same chemical formulation as birth control pills they do cover.
The White House has also often cited the birth control mandate as one of the healthcare law’s most important benefits for women. The Kaiser findings concern the law’s advocates, who have long applauded that feature of the law as well.
“I don’t think these are just problems, these are violations of the law,” said Gretchen Borchelt, vice president for health at the National Women’s Law Center. “These plans are violating the Affordable Care Act and they need to come into compliance.”
Researchers interviewed insurance officials for nine of the 20 plans and reviewed publicly available documents for the rest. It’s extremely difficult, if not impossible, for women to ascertain how their plan covers birth control, they wrote.
And none of the plans offer a formal process for women to request a waiver from coverage limitations due to medical need, even though the Department of Labor has specified that carriers should have such a process in place, they found.
