HHS: Insurers must cover all birth control

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Insurers must cover a wide range of contraceptive methods at no cost to consumers, the Obama administration said Monday in new guidance to health insurance companies.

The guidance from the Department of Health and Human Services (HHS) makes clear that insurers are obligated under the Affordable Care Act to cover at least one version of each of the 18 federally approved birth control methods.

{mosads}“Today’s guidance seeks to eliminate any ambiguity,” HHS said. “Insurers must cover without cost-sharing at least one form of contraception in each of the methods (currently 18) that the FDA has identified for women in its current Birth Control Guide, including the ring, the patch and intrauterine devices.”

The agency made the announcement after a series of reports indicated insurers had conflicting policies on covering contraceptives, despite ObamaCare’s requirement that contraception be offered at no cost. 

The Kaiser Family Foundation, a nonpartisan health research group, reported last month that some insurers were not providing all 18 forms of contraception at no charge. Five of 20 insurance plans it reviewed charged women for a vaginal ring, and one plan did not cover the contraceptive at all.

A separate report from the National Women’s Law Center found problems with coverage of the vaginal ring, the patch and an intrauterine device (IUD). In some cases, insurance companies would “even suggest that a woman switch methods if she does not want any out-of-pocket costs,” according to the report.

America’s Health Insurance Plans (AHIP), the insurers’ trade group, had condemned that study as presenting a “distorted picture of reality.”

“Today’s guidance takes important steps to support health plans’ use of medical management in providing women with safe, affordable health care services,” AHIP President Karen Ignagni said in a statement. “Health plans are committed to promoting evidenced-based decision-making and to ensuring all consumers understand how their coverage works.”

AHIP is happy that the new guidance allows insurers to still use so-called medical management techniques, aimed at controlling costs. So while insurers have to cover one of each of the 18 types for free, they can still take steps like charging patients for more expensive brand-name versions instead of generics.  

Democrats in Congress, led by Sen. Patty Murray (Wash.), had been pushing the administration to clarify the rules for birth control coverage. 

“I’m pleased that with this announcement [HHS] Secretary Burwell is acting to address these violations as well as others that have become barriers to accessing critical preventive care, especially for those in the transgender community,” Murray said in a statement. 

The guidance makes clear that insurers cannot limit preventive services for transgender people based on their sex assigned at birth.

The 18 federally approved types of birth control that now must be offered free include morning-after pills and IUDs, which have been controversial and labeled by conservatives, such as the owners of Hobby Lobby stores, as “abortifacients,” meaning they cause abortion.

The 18 types of contraception are:

• Sterilization surgery
• Surgical sterilization implant
• Implantable rod
• Copper intrauterine device
• IUDs with progestin (a hormone)
• Shot/injection
• Oral contraceptives (the pill), with estrogen and progestin
• Oral contraceptives with progestin only
• Oral contraceptives, known as extended or continuous use that delay menstruation
• The patch
• Vaginal contraceptive ring
• Diaphragm
• Sponge
• Cervical cap
• Female condom
• Spermicide
• Emergency contraception (Plan B/morning-after pill)
• Emergency contraception (a different pill called Ella)

Last updated at 1:43 p.m.

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