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N.Y.’s Schneiderman proposes free birth control access law

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(Bloomberg) — Insurers would be required to increase free access to contraceptives in New York under expanded coverage requirements proposed by state Attorney General Eric Schneiderman.

A bill set to be introduced in Albany Monday by Schneiderman would impose expanded coverage requirements and steeper hurdles for denying benefits or passing along costs to consumers. The measure would require that insurers cover all federally approved birth control methods — including those used by men — and prohibit a review process used by some companies to deny or delay coverage.

The proposal follows reports from health advocacy groups that some insurers may have denied or passed along costs for some forms of birth control such as intrauterine devices (IUDs), hormonal patches and vaginal rings, in violation of a U.S. Department of Health and Human Services (HHS) regulation implementing federal Patient Protection and Affordable Care Act of 2010 (PPACA) preventive services benefits provisions.

See also: Religious challenges to HHS contraceptive rules tossed

The HHS regulation requires most insurers to cover contraceptives for women in the PPACA preventive services package. The PPACA preventive service package provisions require plans to cover services in the package without imposing cost-sharing measures such as copayments. Health plans are allowed to make patients pick up some of the cost of brand-name birth control, if generic versions are available. Birth control methods for men — condoms and vasectomies — aren’t included under the federal requirements.

“New Yorkers should not be penalized by their insurance companies for using the birth control method that they and their medical provider agree is most appropriate for them,” Schneiderman said in a statement. “Ensuring comprehensive, cost-free access to birth control is critical to fulfilling the goals of the Affordable Care Act and to upholding every woman’s right to contraception.”

Senate opposition

The bill may face resistance in the Republican-controlled state Senate, which has been reluctant to support measures related to PPACA.

In 2012, Democratic Gov. Andrew Cuomo resorted to an executive order to create a health exchange under the federal law after Senate Republicans blocked a bill for almost a year. The Republicans said at the time that allowing the exchange would have condoned the president’s law.

In reports published last month, the Washington-based National Women’s Law Center and Menlo Park, Calif.-based Henry J. Kaiser Family Foundation found that some insurers were charging copayments for birth control methods, denying coverage or restricting benefits.

See also: Are some insurers skirting PPACA’s birth control rules?

Some may be violating federal rules, according to the report.

Coverage restrictions

The Kaiser Family Foundation found that some insurers limit coverage of vaginal rings, because they use the same chemical compounds as oral contraceptives, for instance. Some health plans require women to try out less costly contraceptives, such as pills, before progressing to other methods.

Of the 20 plans surveyed by Kaiser, 19 paid for generic emergency contraceptives with no limitations. Eleven covered the Ella pill without imposing restrictions. Ella can prevent pregnancy for up to five days after unprotected sex, two days longer than other such pills, according to Kaiser.

The National Women’s Law Center said it analyzed plans offered by more than 100 insurers during 2014 and 2015 and found that more than half of the companies were violating PPACA. 

Schneiderman sent letters last week to 11 health insurers including Cigna Corp., Excellus BlueCross BlueShield, Empire BlueCross BlueShield and EmblemHealth inquiring whether they violate federal requirements.

Connecticut, California

Other states have taken some actions previously aimed at making sure birth control is provided cost-free to policyholders. In 2014, Connecticut insurance regulators issued a bulletin clarifying prohibitions against cost-sharing for certain women’s health services. The same year, California Gov. Jerry Brown signed a law, which like the New York bill, expanded coverage requirements. The bill didn’t include birth control methods for men.

Under the HHS preventive services package regulations, health plans were to cover virtually all birth control methods for women including pills, shots, implants, and sterilization surgery without imposing co-payments, according to the National Women’s Law Center.

New York’s Comprehensive Contraception Coverage Act of 2015 would “codify” the federal requirements and bring birth control methods for men “in line with the benefits enjoyed by women,” according to Schneiderman. The bill would also allow consumers to obtain larger amounts of contraceptives at one time than currently required under the HHS preventive services package regulations, according to Schneiderman, a Democrat. Obtaining condoms free of cost under the New York bill would require a prescription.

See also: NY bill would require contraception change notification

“This legislation takes critical steps toward breaking down these barriers and providing comprehensive contraceptive coverage for all New Yorkers,” New York Civil Liberties Union Executive Director Donna Lieberman said in a statement.

—With assistance from Freeman Klopott in Albany.


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