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Are some insurers skirting PPACA’s birth control rules?

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One of the enduringly controversial measures included in the Patient Protection and Affordable Care Act is in the news again.

The National Women’s Law Center reported this week that insurers are routinely ignoring PPACA’s guarantee to women that they will have to pay little or nothing for birth control devices and products. In an analysis of 100 insurance plans and their policies in 15 states, the center said insurers are charging patients for basic birth control measures that the law specifically says should be free or low cost.

“Unfortunately, not every woman who should be getting coverage of her birth control without out-of-pocket costs has been able to access this important benefit,” the report said.

The law’s guarantees around birth control and other gender-related insurance costs have already led to considerable litigation from employers who say paying for birth control goes against their religious beliefs. The courts have supported some of the plaintiffs.

Reports of insurers charging for free or low-cost birth control devices and methods first surfaced last summer. Insurers were found to be billing patients for the “guaranteed” birth control check list items, or disguising charges by including fees for other services in “bundled” package bills.

The center’s findings appear to be at odds with an earlier study undertaken by the Guttmacher Institute and published by the journal Contraception. That study indicated a major increase in insurance plans to covered the items stipulated by the law.

For instance, the institute’s study reported an increase from 20 percent in 2012 to 74 percent in 2014 in plans covering the vaginal ring. IUD coverage rose from 45 percent to 62 percent, the study said.

But the National Women’s Law Center cited both IUD and vaginal ring coverage as among the methods that were not being covered as directed by PPACA. The center said it has received numerous complaints from women in all 50 states regarding birth control plan coverage.

The Department of Health and Human Services was quick to assert that it would be investigating the allegations. In an email to the news source The Hill, an HHS spokesperson said the department takes “reports of non-compliance very seriously.”

But an insurance industry executive charged that the allegations were seriously flawed.

“To use highly selective anecdotes to draw sweeping conclusions about consumers’ coverage does nothing to improve the quality, accessibility, or affordability of health care for individuals and families,” CEO Karen Ignagni of America’s Health Insurance Plans wrote in a statement to The Hill.