Contraceptive Mandate Considerations

Women’s health care has finally been brought to the forefront of public discussion.  When it comes to preventative health services, previous laws and corresponding insurance coverage denied women equal coverage. With the passing of the Patient Protection and Affordable Care Act (PPACA), which allowed for a Contraceptive Mandate (Mandate), women across the country are benefitting from access to birth control without cost-sharing. [1]
According to the Department of Health and Human Services (HHS), an estimated 27 million women currently benefit from these no-cost sharing services. [2]  Even though some employers are exempt from providing contraceptive coverage to their employees, 41% of all workers in non-exempt organizations received an expanded pool of affordable benefits through their employer-sponsored insurance. [3] 

In addition, studies have shown that by removing the previous cost-barrier surrounding birth control, women have been able to take control of their own reproductive health by preventing any unintended pregnancies and lowering the overall number of requested abortions. [4]  Additionally, research has found that access to contraception is a critical component of helping women achieve economic success. [5]  Since birth control allows women autonomous family-planning, women are now capable of pursuing their financial goals without the added stress and worry of unintended pregnancies. [6]  Furthermore, the Guttmacher Institute released new data that suggests that publicly funded birth control saves the government billions of dollars by preventing unintended births that may require women to seek governmental support through welfare services in order to raise that child. [7]

Although the Mandate may have certain benefits that significantly impact women’s health and insurance coverage of those preventive services, every newly implemented law faces criticism in its application.  The Mandate may provide that health plans and insurers must cover women’s preventive services without cost-sharing, but women still must pay out-of-pocket for name brand prescription birth control when a generic equivalent is available. [8]  The Mandate also states that over-the-counter contraceptives are covered without cost-sharing only when patients come in with prescriptions from a physician. [9] Requiring a prescription, however, for an over-the-counter item only increases the burden on already over-burdened primary care systems, driving up administrative costs. [10]  It is unclear what over-the-counter products are included under the Mandate and, to make the matter worse, the insurance industry has absolutely no way of tracking these purchases in order to reimburse policy holders for any out-of-pocket expenses personally accrued. [11]

Furthermore, the Mandate includes only female-based contraception and preventive services and thus does not apply to methods and procedures intended for men. [12]  This ultimately means that male-based contraceptive methods are not covered by the preventive services Mandate, which may leave the Mandate open to discrimination claims.

The Mandate has already been granted a writ of certiorari by the Supreme Court to hear on the issue of whether corporations may refuse to provide insurance coverage for contraception to their employees, based on the religious views of the corporation’s owners. [13] Therefore, regardless of the benefits and the pitfalls of the Contraceptive Mandate, unsettled legal challenges still could upend this landmark law.

 

 

References:

[1] Patient Protection and Affordable Care Act of 2010, Pub. L. No. 111-148, §2713, 124 Stat. 119, 131 (2010).

[2] Tara Culp-Ressler, As Obamacare’s Birth Control Benefit Hits Its One Year Anniversary, It’s Helping 27 Million Women, Think Progress (Aug. 1, 2013),http://thinkprogress.org/health/2013/08/01/2397101/obamacare-birth-control-anniversary/.

[3] Id.

[4] Id.

[5] Id.

[6] Id.

[7] Id.

[8] Julie Appleby, Five Questions About The Health Law’s Mandate To Cover Birth Control, Kaiser Health News  (Feb. 27, 2012),http://www.kaiserhealthnews.org/stories/2012/february/27/five-questions-health-law-mandate-birth-control.aspx.

[9] Id.

[10] Id.

[11] Id.

[12] Id.