Insurance companies have to pay for birth control, mammograms and well-woman visits without charging co-pays and without a fight, the federal government said in a stern reminder Monday.
The 2010 Affordable Care Act sets out not only to get health insurance to all Americans, but to make sure that the policies people have cover basic care. It’s also aimed at lowering costs. Providing women with birth control is cheaper than paying for unplanned pregnancies, and cancer screening can catch cancer while it’s still easy and less expensive to treat – or can even prevent cancer altogether.
That means covering some pricey genetic tests and it also means covering transgender people, the Health and Human Services, Treasury and Labor departments said in a joint statement.
But some women’s advocacy groups and a few members of Congress have complained that some insurance companies aren’t doing what they are supposed to.
“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, according to the guidance,” the statement says.
“Tens of millions of women are eligible to receive coverage of recommended preventive services without having to pay a co-pay or deductible, including contraception.”
“If a woman is at increased risk for having a potentially harmful mutation in genes that suppress tumors -– the BRCA-1 or BRCA-2 cancer susceptibility gene -- a plan or issuer must cover the preventive screening, genetic counseling, and BRCA genetic testing with no cost-sharing, as long as the woman had not been diagnosed with BRCA-related cancer,” the statement adds.
“Women with the BRCA-1 and 2 mutation have a risk of breast cancer that is about five times the normal risk, and a risk of ovarian cancer that is about 10 to 30 times normal.”
Insurance plans also have to cover contraception and preventive services for dependent children on their parents’ account. “This includes recommended services related to pregnancy, including preconception and prenatal care.”
Cecile Richards, president of the Planned Parenthood Action Fund, said some women had been paying $600 a year or more for birth control even when they were insured.
“This is a victory for women and the more than 30,000 Planned Parenthood supporters who spoke out to ensure all women, no matter what insurance they have, can access the full range of birth control methods without a co-pay or other barriers,” Richards said.
“This practice is a shameful new low for the insurance industry," added Ilyse Hogue, president of NARAL Pro-Choice America.
“Recent reports by NARAL Pro-Choice Washington, the Kaiser Family Foundation and the National Women’s Law Center all found that insurance carriers continue to wrongly charge women out-of-pocket costs for their contraceptives—costs the ACA (Affordable Care Act) eliminated—in addition to the cost of their insurance plans."
Last month, the Kaiser Family Foundation released a report that found almost all plans cover intrauterine devices (IUDs), which are the birth control devices most recommended by experts.
But it was hit and miss. Kaiser found one health insurance company did not pay for ParaGuard, which is the only non-hormonal IUD on the market. It found most pay for the Plan B emergency contraceptive pill or its generic equivalents, but many either do not cover the “ella” brand emergency contraceptive pill, or charged patients or limited what they would pay for.
"The Affordable Care Act was a major step forward in helping women get the health care services they need to stay healthy,” HHS Secretary Sylvia Burwell said in a statement.
“Tens of millions of women are eligible to receive coverage of recommended preventive services without having to pay a co-pay or deductible, including contraception.”
“We know that increased access to birth control has helped bring teen pregnancy rates to a 40-year low and we must continue to drive forward policies that build on this progress.”
“We know that increased access to birth control has helped bring teen pregnancy rates to a 40-year low and we must continue to drive forward policies that build on this progress," Richards added.
The Centers for Disease control and Prevention reports the rate of births among teenagers 15 to 17 has fallen by more than 63 percent since 1991.
The Supreme Court has ruled that closely held, for-profit companies can claim a religious exemption to the Obamacare requirement that they provide health insurance coverage for contraceptives.
Polls have shown that 69 percent of Americans support the requirement that insurance companies pay for birth control.
“Insurers reported they’ve received very few requests for an accommodation from religiously affiliated employers with an objection to some or all contraceptives,” Kaiser said in a statement.
