Insurers violating ACA by failing to cover contraception, senators write

A number of health insurers are not complying with the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), by failing to provide coverage for FDA-approved contraception and neglecting to provide accurate information about available health care services, according to a letter sent by Sen. Patty Murray (D-Wash) and 38 Senate Democrats to HHS Secretary Sylvia Mathews Burwell.

The senators expressed distress over the news that some insurers have not been complying with the provisions of the ACA, which amended Section 2713 of the Public Health Service Act to require contraceptive coverage for certain entities: “Unfortunately, we write with serious concerns that some insurers are failing to uphold the standards set in the Affordable Care Act and as a result leaving women without the health care services they are entitled to under the law.”

Citing recent reports by the Kaiser Family Foundation, the National Women’s Law Center, and Northwest Health Law Advocates and NARAL Pro-Choice Washington, Senator Murray reported that some qualified health plans are not in compliance with the ACA by providing inaccurate information, incorrectly charging for contraception, or denying coverage altogether.

The letter also requested that HHS provide greater clarity regarding the ACA’s mandate that requires coverage of all FDA-approved forms of contraception, increase consumer awareness of the ACA’s contraception benefit requirements, and encourage states to enforce compliance with the law. HHS should also take appropriate enforcement actions and encourage states to set up compliance programs. The senators also requested a written update from HHS relating to the actions it has taken to ensure compliance with the ACA.

Senator Murray also recently sent a letter to eight Washington state insurers for failing to provide accurate information relating to contraception coverage and imploring them to take proactive steps to increase transparency. Two of the insurers, Coordinated Care and Bridgespan already responded by committing to address the issues outlined in her letter.

Earlier this year, Senator Murray and other colleagues introduced the 21st Century Women’s Health Act which focuses on women’s health issues, including clinics, primary care, and preventative services like contraception (see Senators #standwithwomen, push bill for women’s health, Health Reform WK-EDGE, March 11, 2015).

Response

Possibly driven by the letters and reports, the Departments of Labor, Treasury, and HHS issued an FAQ noting that, in order to be compliant with the ACA, health care plans must cover, without cost sharing, the full range of FDA-approved methods for contraception (see Plans must cover the full range of FDA-approved contraceptive methods without cost sharing, Health Reform WK-EDGE, May 13, 2015).