Hey insurance companies, ‘coverage of birth control is not a suggestion, it’s the law’

The Affordable Care Act requires insurers to cover contraception for women with no out-of-pocket cost. Despite the law, insurance companies routinely violate the ACA by refusing to cover certain products, imposing administrative hurdles and other violations.

The Biden Administration recently released additional guidance to insurance companies that requires coverage without cost-sharing of every FDA-approved product that does not have a generic equivalent.

More than 150 U.S. House and Senate legislators are also reaching out to health insurers, sending a letter to UnitedHealth Group and America’s Health Insurance Plans, whose membership includes health insurers across the country.

The letter urges health insurers to comply with the law and put an end to the practice of forcing women to pay out of pocket for the birth control method that works best for them.

“We write to express our concerns that your members are not complying with the Affordable Care Act contraception coverage requirement, and to urge them to consider immediate adoption of the therapeutic equivalence standard outlined by the Departments of Health and Human Services, Labor, and Treasury on January 22, 2024,” wrote the legislators. “Despite repeated clarification of these requirements from the Departments, multiple investigations – including by the House Oversight Committee – have revealed that plans routinely violate the ACA by refusing to cover certain products, imposing administrative hurdles like prior authorizations and step therapy (fail first protocols), and requiring patient cost-sharing.”

“We urge your plans to immediately consider adopting the therapeutic equivalence standard to ensure patients’ access to the contraceptive products they need, as required by the ACA,” the letter said.

The letter has been endorsed by Planned Parenthood Federations of America, Reproductive Freedom for All, Power to Decide and Physicians for Reproductive Health.

“Under the Affordable Care Act, comprehensive coverage of birth control is not a suggestion, it’s the law. Yet, insurance companies are blatantly disregarding this vital provision,” said Gretchen Borchelt, vice president for Reproductive Rights & Health, National Women’s Law Center.

The letter was led in the U.S. Senate by Senators Elizabeth Warren (D-MA), Catherine Cortez Masto (D-NV) and Tina Smith (D-MN), and in the U.S. House by Representatives Lois Frankel (D-FL), Ayanna Pressley (D-MA), Kathy Manning (D-NC) and Judy Chu (D-CA).