Health insurers are violating new requirements in the Affordable Care Act, say some of the law’s strongest advocates.
Two lengthy reports released Wednesday find that many insurers are either denying coverage for certain services or not covering them as mandated by the 2010 healthcare law.
Researchers studied plans in 15 states around the country, and found at least one plan in each state that violates the healthcare law by illegally collecting co-payments or imposing coverage limitations on certain services.
For example, 14 plans in seven states offer maternity coverage that does not comply with the law. More than 50 plans in 13 states offer preventive services coverage that falls short, the researchers found. They also found widespread violations of the law’s requirement for plans to cover all types of Food and Drug Administration-approved birth control.
Commissioned by the National Women’s Law Center — a group that supports the law’s insurance coverage provisions — the reports focus on health services specifically accessed by women.
The healthcare law requires insurers to cover healthcare services that are considered “preventive,” like screenings, immunizations and birth control, with no extra, out-of-pocket costs for the consumer. Plans being sold in the law’s new insurance marketplaces must also cover another set of services deemed essential, including wellness visits and chronic disease management.
The Obama administration and Democrats have used those benefits as big selling points for the healthcare law, as many plans prior to its passage imposed more coverage limits.
But there has been increased focus lately on how some still are not fully complying with the coverage requirements, even though they have been in place for some time. That’s a big concern to health advocates, who have long complained about stingy insurance plans.
“Insurance companies are breaking the law by denying women coverage to which they are entitled,” said Gretchen Borchelt, vice president for health at NWLC. “Insurance companies must comply with the law, and regulators should do a better job enforcing it.”
“Otherwise, women will again be at the mercy of insurers whose previous discriminatory practices drove the need for reform in the first place,” she said.
