by Nina Roumell, Strategic Engagement Fellow
Being a woman just got easier. Well, actually that happened August 1, 2012. As part of the health reform law passed last year, all insurance plans are required to provide preventive services to women with no cost sharing (no copays, deductible payments, etc.).
The services include all contraceptive methods, sterilization procedures, and patient education and counseling approved by the Food and Drug Administration (FDA). In the proposed guidelines from last winter only houses of worship with a fundamental objection to these services were exempt from providing contraception services in their employer based health coverage. However, other faith-based non-profit organizations were dissatisfied and argued that they too had a moral objection in providing contraception and pushed for exemption. On the other hand, consumer advocates argue that it is important that women get the care they need regardless of their employer or their employer’s religious beliefs.
A week ago, the Obama administration issued the final ruling on employer based healthcare and acknowledged the needs of women and the concerns of religious employers. Almost all employer-sponsored health insurance is mandated to include contraception coverage. Non-profit religious employers, such as hospitals and universities, have an accommodation in which their employees may still receive contraception services without using company dollars. These services must be offered by January 1, 2014 as opposed to August of 2013, which was suggested in the proposed guidelines. However, houses of worship as defined by the Internal Revenue Code are completely exempt from the mandate. There is no exemption or accommodation for for-profits, upsetting companies such as Hobby Lobby. The owners of Hobby Lobby sued, arguing they run their company on a set of religious principles and should not have to pay for contraception. On Thursday, the 10th Circuit Court of Appeals ruled that Hobby Lobby has an adequate case and sent it back to the lower court for further consideration.
In its final regulations, the Department of Health and Human Services devised an accommodation process for ensuring employees of non-profit religious entities have access to contraceptive care. First, religious employers who provide coverage will notify its health insurance plan that it will not be covering contraceptive services. The health insurance plan will then notify the employees that it will be covering contraceptive services, rather than the employer. After using a contraceptive service, a woman will send her claim to the health insurer to have her contraceptive services covered. Larger companies often “self insure,” using a third party administrator. Third party administrators of religiously affiliated companies will need to purchase an insurance-like product, which provides contraceptive services. The Federal Government will adjust the user fee paid by insurers to operate in the Federally Facilitated Exchange to account for the cost of the contraceptive coverage under this accommodation process.
Although these processes may seem complex, they help women access the basic care they need, without unpredictable costs. “This is a historic moment for women’s health and economic security,” Planned Parenthood president Cecile Richards said following the final ruling. Contraceptives are essential in family planning and proper birth spacing has maternal and child health benefits. Women should not have to choose between filling their pantry or filling their prescription. 99% of women have relied on contraception at some point in their life, and the Friday announcement will ensure that women can continue obtaining these services. Women will be able to get the care they need when they need it regardless of their employer.