Guest blog by Lois Uttley, MPP, Director, Raising Women’s Voices-NY.
More than 55 million women across the United States have gained contraceptive coverage without co-pays as part of their health insurance policies, because of the Women’s Preventive Services Amendment to the Affordable Care Act (ACA). This coverage benefit, which applies to most employer-sponsored insurance as well as to health plans purchased through ACA marketplaces, is estimated to have saved the average woman about $240 a year in avoided out-of-pocket costs.
However, research by Raising Women’s Voices-NY has consistently found that insurers offering plans in New York are not always complying with ACA birth control coverage requirements. (Similar problems have been found in other states.) RWV-NY wrote to state officials in 2014 and 2016 to cite numerous apparent violations of the contraceptive coverage rules by New York insurers. Problems identified included failing to cover some of the 18 FDA-approved methods of contraception – especially IUDs, the patch and emergency contraception – inappropriately charging co-pays for some contraceptives and giving inaccurate or confusing information to women who called health plan customer service lines.
This week, the Cuomo administration took action against one New York insurer – Excellus Health Plans – for illegally denying consumers contraceptive coverage, among other problems. The state Department of Financial Services (DFS) fined Excellus $1 million for these violations. That action underscored the Department’s intention to hold insurers accountable for providing contraceptive coverage without co-pays. DFS sent a circular letter to insurers back in January, reminding them of their obligation to comply with the birth control coverage requirements of the ACA, and asserting that New York law independently requires such coverage.
The Cuomo administration went even further to articulate and expand contraceptive coverage requirements in New York through a regulation proposed in January, just as women’s organizations were expressing concern about a new federal administration that could move to rescind the ACA contraceptive coverage benefit. The new Secretary of Health and Human Services, Tom Price, has been an outspoken opponent of contraceptive coverage requirements and of the ACA as whole.
Both Health Care For All New York and Raising Women’s Voices-NY submitted comments in March supporting the proposed state contraceptive coverage regulation and suggesting ways to make the requirements even stronger, such as by including coverage of male contraceptive methods (vasectomies and condoms) and requiring insurers to cover dispensing of a 12-month supply of birth control pills at once (which has been shown to help women avoid gaps in contraceptive use caused by having to refill prescriptions).
HCFANY and RWV-NY are also supporting legislation – the proposed Comprehensive Contraceptive Coverage Act – that would place robust contraceptive coverage requirements into state law. The bill has passed the state Assembly, but has not seen action in the state Senate.