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 The 2010 law, popularly called Obamacare, requires most health
insurance plans to provide coverage for birth control without a
patient co-payment, which can be as much as $50 per month for birth
control pills or $1,000 for long-acting contraceptives such as
intrauterine devices.
California, Maryland, Vermont and Illinois since 2014 have enacted
statutes codifying the Affordable Care Act's contraception mandate
in state law and expanding on the federal law's requirements.
Democratic lawmakers in New York, Minnesota, Colorado and
Massachusetts said they are pursuing similar measures this year,
with Obamacare under mortal threat in Washington.
New York's Democratic attorney general, Eric Schneiderman, on
Wednesday introduced such a measure in his state's legislature that
would expand on the Obamacare contraception mandate.
"Women across New York are very concerned that Republican efforts to
repeal the ACA will mean the loss of the contraception on which they
rely," Schneiderman said.
"I won't hesitate to act to protect New Yorkers' rights - including
the right to choose, and the right to birth control - no matter what
a Trump administration does," Schneiderman added, referring to
abortion rights.
Trump, who succeeds Democratic President Barack Obama on Jan. 20,
and his fellow Republicans in Congress have made dismantling
Obamacare their "first order of business," as Vice President-elect
Mike Pence put it on Jan. 4. [nL1N1EU0RW]
Republicans in Congress have not presented a detailed proposal for
repealing and replacing the law but many Republicans and religious
conservatives have opposed the Obamacare contraception mandate.
[nL1N1EU0RW]
Twenty-eight of the 50 states currently have laws requiring private
insurers to provide coverage for birth control. But not all the laws
affect all insurance plans, and only a few mandate cost-free birth
control.
OUT-OF-POCKET EXPENSES
The Obamacare contraception mandate has applied since 2012 to most
new insurance plans including employer-provided coverage.
In 2013, for example, the mandate saved U.S. women more than $1.4
billion in out-of-pocket expenses for birth control pills, according
to a report by University of Pennsylvania researchers. Almost 6.9
million privately insured U.S. women used the pill that year.
The legislative move by some states, most of them Democratic
governed, is designed to clear up uncertainty for some of the 55
million women who now have access to free contraceptives and related
treatments under the Affordable Care Act.
Conservatives also have chipped away at the Obamacare mandate in
court. The U.S. Supreme Court ruled in 2014 that forcing
family-owned businesses to pay for employee insurance coverage for
birth control ran afoul of another federal law safeguarding
religious freedom.
The Supreme Court last May sent another legal challenge by nonprofit
Christian employers back to lower courts to reconsider the matter
after tossing out their rulings favoring the Obama administration.
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"I think it is even more important now," said Colorado state
Representative Susan Lontine, who last year co-sponsored a
contraception coverage bill in her state's legislature that did not
get passed but she expects to be resurrected in 2017. "We don't know
what will happen on the federal level."
California in 2014 became the first state to pass a contraception
mandate that went further than the Obamacare language. Maryland,
Vermont and Illinois last year passed laws that also eliminated
co-pays for vasectomies and allowed women to fill a birth control
prescription for at least six months rather than one to three.
The New York legislation would allow women to fill multiple months
of a birth control prescription, prohibit private insurers from
"medical management" reviews that could limit or delay contraception
coverage, and provide coverage for vasectomies without a co-pay.
Within a matter of months, the Trump administration even without
congressional action could drop contraception from Obamacare's list
of preventive services that health insurance plans must cover
without out-of-pocket costs, said Laurie Sobel, senior policy
analyst at the nonprofit Kaiser Family Foundation.
If repealed, some employers might choose to maintain the coverage
without a co-pay because it is a relatively inexpensive benefit
popular with employees.
The proportion of privately insured women who paid nothing out of
pocket for birth control pills increased from 15 percent in the fall
of 2012 to 67 percent in the spring of 2014 during the time when the
coverage went into wide effect, according to the Guttmacher
Institute research organization.
The no-cost contraceptives coverage also spurred women to switch to
long-acting methods such as the IUD, which is offered in the United
States by Bayer, Teva, Allergan and Medicines360, studies have
found.
More than 77 percent of women and 64 percent of men support the
no-cost contraceptives coverage, according to a 2015 Washington
Post/Kaiser Family Foundation survey.
(Reporting by Jilian Mincer; Editing by Caroline Humer, Edward Tobin
and Will Dunham)
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