Consumer / Employer, Payers, Legal

‘A Proactive and Necessary Step:’ NFPRHA Applauds Proposed Rule on Birth Control Coverage

Under the proposed new rule, employers are no longer able to be exempt from covering contraception due to moral convictions, but religious exemptions still remain. It’s an important move from the government during the reproductive health crisis, one advocate said.

After the Biden Administration on Monday released a proposed new rule that would expand birth control coverage under the Affordable Care Act, one advocacy organization is praising the move.

“At a time when the reproductive health crisis continues to grow in the U.S., it has become even more important for people who want contraception to be able to access it from family planning providers they trust,” said Mindy McGrath, senior director of policy and communications at the National Family Planning & Reproductive Health Association (NFPRHA). “The draft rule released by HHS is a proactive and necessary step toward making access to contraception a reality for more people across the country.”

Women enrolled in group health plans or individual health insurance through the ACA can receive women’s preventive services, including birth control and contraceptive counseling, for no cost. During the Trump administration, a regulation was finalized in 2018 that allowed private health plans and insurers to exclude coverage of contraceptives for “religious beliefs and moral convictions,” the U.S. Department of Health & Human Services (HHS) said. Under the new proposed rule, moral exemptions would be removed while religious exemptions would remain.

Laurie Sobel, associate director of women’s health policy at Kaiser Family Foundation, noted the change in the new regulations. However, she said that she doesn’t know how many employers actually claimed the moral exemption in previous years.

Also under the 2018 rule, employers and private colleges and universities are able to opt for an accommodation that allows the insurance company to provide contraceptive coverage in a way that is removed from the organizations. Through this accommodation, an employer with a moral or religious exemption can sign a form notifying their insurer that they don’t want to cover contraception through their health plan, and that insurer would make sure the employees still have coverage separate from their employer. However, the employers that don’t opt for this accommodation leave those employees without any contraceptive coverage. 

With the proposed rule, there would be an “independent pathway” for those enrolled in plans from employers with a religious exemption. This would allow individuals to access birth control on their own from a willing provider for no cost. That provider would then be reimbursed by an insurer on the Affordable Care Act exchanges.

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McGrath said NFPRHA is pleased to see that the Biden Administration is working to change some of the regulations created by the Trump Administration.

“The regulations put in place by the Trump administration were designed to deny countless people coverage for birth control and reverse some of the important public health progress made under the Affordable Care Act in recent years,” McGrath declared. “We are pleased to see the Biden administration tackling this critical issue and look forward to the opportunity to work with them to make contraceptive coverage a reality for all those who seek it.”

Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America, echoed McGrath’s comments.

“Access to birth control is critical to reproductive freedom. It gives people the reins to decide their own futures,” Johnson said in a statement. “Employers and universities should not be able to dictate personal health care decisions and impose their views on their employees or students … We appreciate the Biden-Harris administration for taking steps to reverse this harmful policy and continue to champion sexual and reproductive health care. We look forward to the administration using all levers of government to expand access to health care.”

While expanding access to birth control is a “critical first step” in the wake of the Dobbs v. Jackson decision, it doesn’t mean abortion services aren’t needed, McGrath said.

“Recognizing that no amount of contraception will ever end the need for abortion, increasing the availability of contraception for those who want it is nevertheless imperative in this crisis moment,” McGrath said.

Predictably, some groups oppose the proposed rule.

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