ACA contraceptive coverage requirements are confusing, healthcare attorneys say

The Health Resources and Services Administration should do more to clarify which contraceptives are required to be covered at no cost under the ACA and make sure new methods are added to coverage requirements, healthcare attorneys write in an opinion for Health Affairs. 

In a Sept. 28 article for the site, attorneys at healthcare-focused firm Epstein Becker & Green write that rules for which contraceptives must be covered are confusing for patients and providers. Currently, payers are required to automatically cover at least one contraceptive from 17 categories defined by the FDA.

For a patient to access a contraceptive method not automatically covered by their insurance, their doctor has to provide documentation that the method is medically necessary. The authors said this requirement can create a burden on patients and providers. 

The HRSA should also create a process for new contraceptive products that don't fit within existing categories to be added to required coverage, the authors said. 

"Access to certain contraceptives is already at risk due to the Dobbs decision: The HRSA and the Biden administration at-large should take all reasonable steps to ensure maximum access to the widest possible array of effective contraceptives, as was intended by the ACA," the authors wrote.

 
Read the full opinion here.

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