Administration workaround gives women access to contraceptives


Employees of religious non-profits can receive separate coverage for contraceptive services

The Obama Administration has announced new rules to help ensure that women-whose coverage may have been threatened under June’s Supreme Court ruling in the Burwell v. Hobby Lobby case-receive coverage for recommended contraceptive services without cost sharing under the Affordable Care Act (ACA). The rules address both non-profits and closely held for-profit entities. 

According to a statement by the Department of Health and Human Services (HHS), an interim final rule will allow eligible non-profits to provide written notice to HHS of  their religious objection to providing coverage for contraceptive services.

HHS and the Department of Labor will notify insurers and third-party administrators so enrollees in plans of such organizations can receive separate coverage for contraceptive services with no additional cost to the enrollee or the employer. 

“These new rules will make it easier for all women to have access to contraception,” says Sherry Rohlfing, principal, Delta Sigma, LLC, a consulting practice specializing in strategic problem solving for managed care organizations. “It may get complicated for health plans, though, since they will need to coordinate with their employer clients and HHS for those employers who decide to opt out of coverage.”

A proposed rule was also issued to extend the same accommodation to certain closely held, for-profit entities such as Hobby Lobby. Under the proposal, these companies would not have to contract, arrange, pay or refer for contraceptive coverage for which they object to on religious grounds. The proposal also seeks comment on how to define a “closely held, for-profit company” and whether other steps are needed for implementing the policy. 

Commitment to coverage

According to a statement released by HHS, the rules were made in response to the Supreme Court’s decisions and balance the administration’s “commitment to helping ensure [that] women have continued access to coverage for preventives services important to their health” while also respecting the beliefs of religious entitites. 

The rules maintain the existing accommodation for certain religious  non-profits, but creates an additional pathway for eligible organizations to provide notice of their objection. 

“Women across the country deserve access to recommended preventive services that are important to their health, no matter where they work,” said HHS secretary Sylvia Burwell. “[This] reinforces our commitment to providing women with access to coverage for contraception, while respecting religious considerations.”

In July 2013, final rules were published that provided women with coverage for recommended preventive care, including all FDA-approved contraceptive services prescribed by a healthcare provider, without cost-sharing, while allowing certain non-profit religious employers that object to contraceptive coverage on religious grounds to not have to contract, arrange, pay or refer for such coverage for their employees or students.

“The administration continues to encourage Congress to act to ensure that women affected by the Supreme Court’s Hobby Lobby decision have access to the same coverage options offered to others, while it begins the process of soliciting feedback to determine how, through rulemaking, it can ensure that the religious concerns of organizations are respected and women are able to get coverage of recommended preventive services without cost sharing, as intended under the healthcare law,” the statement says. 

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