First on CNN: Biden administration ramps up Obamacare contraceptive mandate


Biden administration wants to make it easier for women to access free birth control under the Affordable Care Act, reverse Trump-era rule undermines the law’s contraceptive mandate for employer-provided health insurance plans.

The proposed rule, announced Monday by the Departments of Health and Human Services, Labor and Treasury, would remove immunity from the mandate that would allow employers to refuse to commit a crime. virtue. It will also create an independent pathway for individuals enrolled in employer-provided plans with religious exemptions to access contraceptive services through a willing provider. free of charge.

The proposed rule would leave in place the existing religious exemption for employers who object, as well as optional accommodation for contraceptive insurance.

A senior HHS official told CNN that the administration had introduced the proposed rule keeping in mind employers’ concerns about religious objections and their workers’ need for contraception.

“We had to really think about how to do this in a way that would please both sides, but we think we’ve found a way,” the official said, stressing. that it will not affect religiously affiliated employers.

Students at religiously affiliated colleges will have access to extended accommodation, the same as workers in group health plans for which an employer has requested an exemption.

Now that the proposed rule has been published, the public will have the opportunity to comment over the next few months. Officials expect thousands of public comments and it will take “many months” before the rule can be finalized.

HHS hopes the proposal will affect more than 100 employers and 125,000 workers, primarily through providing a proposed independent route for employees to receive free contraception.

Women using that route will receive their contraception from a participating provider, who will be reimbursed by an insurance company in exchange for the Affordable Care Act. In return, the insurer gets a credit for the user fees it pays the government.

“If this rule were finalized, individuals whose health plans would otherwise be subject to the ACA’s preventive services requirements but would not cover contraceptive services because of ethical objections would ethical or religious and employer-sponsored or college or university did not vote for Chiquita Brooks-LaSure, the Administrator of the Centers for Medicare and Medicaid Services said in a press release.

How many people benefit, however, will depend on whether women and their health care providers know the path to independence exists and whether providers and insurers know what to expect. willing to set it up or not.

“We will have to see how widely that information is spread and in what ways to providers and individuals,” said Laurie Sobel, deputy director of Women’s Health Policy at the Kaiser Family Foundation. . to show takeup of the path.

But the American Federation of Planned Parenthood has cheered the initiative.

“Employers and universities cannot make individual healthcare decisions and impose their views on staff or students,” said Alexis McGill Johnson, Group CEO. their. “ACA requires that health plans cover all forms of birth control with no out-of-pocket costs. Now, more than ever, we must defend this fundamental freedom.”

The requirement to provide free contraception is not included in the Affordable Care Act. Instead, HHS under former President Barack Obama included it as one of the women’s preventive services that all private insurance plans must provide free of charge.

The mandate has been controversial from the start, sparking lawsuits from religiously affiliated employers and well-organized companies alleging it violates their beliefs. Waivers and accommodation are already available to such employers.

However, the Trump administration has undermined this mandate. Below regulations issued in 2018, entities with “sincere religious beliefs” against providing contraception are not required to do so. That provision also extends to organizations and small businesses that protest “based on moral beliefs not based on any particular religious belief.”

The rules also include an optional adjustment that would allow protesting employers and private universities to remove themselves from providing birth control coverage while still allowing workers and their dependents access to contraceptives. But employers or universities have to voluntarily choose where to stay, which risks leaving many out.

Trump administration changes temporarily blocked after a Pennsylvania district court judge ruled nationwide order in 2019. But next year, The Supreme Court ruled that the government could extend exemptions to employers who have religious or moral objections to contraceptive coverage.

At the time, the National Women’s Law Center estimated that the ruling would affect about 64.3 million women in the United States whose insurance includes birth control and other preventive services without pay out of pocket.

Employers are not required to notify HHS if they have an ethical objection. The agency estimates that about 18 employers have claimed the waivers and about 15 employees are affected.

However, if the rule is finalized, senior HHS officials say it is “very likely” that there will be potential lawsuits brought by religiously affiliated employers – similar to those what was seen in the past.

“They have no new obligation to participate in any kind of process. This is simply an additional channel for employees in employer health plans to access contraceptive services,” said another senior HHS official.

The task of contraception has taken on increasing importance now that The Supreme Court overturned Roe v. Wadeallows many states to impose severe restrictions on access to abortion.

By contrast, the Biden administration has focused on continued access to free contraceptives. The Secretary of Health, Labor and Finance last year met with health insurers and issued guidance highlighting Obamacare’s contraceptive coverage requirements for private insurance under the Caregiving Act. Good price.

“More than ever, access to and coverage of contraceptives is critical as the Biden-Harris Administration works to help ensure women everywhere can get the contraception they need, when they need it and – thanks to the ACA – without having to go out – out-of-pocket,” HHS Secretary Xavier Becerra said in a press release.

This story has been updated with additional information.


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