State lawmakers aren’t waiting to see what GOP repeal of the Affordable Care Act (ACA) will look like or if the Trump administration will follow through on its promise to gut access to contraception without co-pay. At least eight states have taken a proactive approach and enshrined Obamacare’s birth control benefit into their own laws.
Over the past year, lawmakers in some states have passed legislation protecting access to contraceptives, ensuring that provision of the ACA remains intact in their states, no matter what congressional Republicans or the Trump administration do to roll back access. By one estimate, more than 55 million women can now get birth control without out-of-pocket costs because of Obamacare. But that access is not guaranteed: Republican leaders in the Senate have repeal of the law squarely in their crosshairs, even if they’re having trouble gathering the votes to make it happen, and Health and Human Services Secretary Tom Price says “there’s not one” woman who can’t afford birth control.
Some GOP-held legislatures, meanwhile, have taken steps to restrict ready access to contraceptives. In Iowa, after a Republican-backed law cut state funding for Planned Parenthood by about $2 million because the reproductive health-care organization provides abortion care, a new state family planning program directs people seeking birth control services to a list of providers that includes Catholic-affiliated clinics, which often oppose the use of contraceptives. Religiously affiliated groups en masse have successfully fought against the birth control benefit all the way up to the Supreme Court to avoid providing their employees with contraception coverage.
The state protections vary, but frequently include provisions that require insurers cover a range of contraception, such as birth control pills and long-acting intrauterine devices. Some even allow pharmacists to dispense the medication without having a doctor’s prescription, and Democratic-majority legislatures in Oregon and California require that insurers cover abortion services. In Oregon, that legislation now covers abortion at no out-of-pocket cost to consumers.
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Here’s a list of states that have moved to protect contraceptives without co-pay and what they have done:
- Hawaii Gov. David Ige (D) signed a bill July 3 that requires insurers to cover contraceptives at no out-of-pocket cost to consumers. The bill authorizes pharmacists to prescribe and give a 12-month supply of contraceptives to patients, and for pharmacists to be reimbursed for doing so. It is effective immediately.
- Oregon Gov. Kate Brown (D) says she’ll soon sign a bill that requires insurers to cover reproductive care, including birth control, at no out-of-pocket cost to consumers. The bill would require insurers cover abortion care without co-pay and take effect in mid-January 2018.
- In Maine, lawmakers in May passed a bill mandating insurers cover at least one contraceptive in each method of contraception at no out-of-pocket cost to patients. The law takes effect without the governor’s approval 90 days after the legislature adjourns.
- Nevada’s Republican Gov. Brian Sandoval signed bipartisan legislation June 5 that requires all public and private health plans to cover up to a 12-month supply of contraceptives without co-pay. The law is effective January 1.
- A bill pending in Massachusetts would outlaw consumer cost sharing for contraceptives, though its prospects appear uncertain in this legislative session.
- A bill in New York would have similarly required insurers not charge people for contraceptives, but that bill died in the state senate in June.
- Illinois’ Gov. Bruce Rauner (R) in July 2016 signed a bill that requires individual or group health insurance plans to cover contraception, including contraceptive devices, at no out-of-pocket cost to patients. The law does not apply to employers with self-insured health plans, but it does require insurance companies cover a 12-month supply of contraceptives.
- Maryland’s Gov. Larry Hogan (R) in May 2016 signed a bill that prohibits state-regulated insurance plans from charging consumers for contraceptives and vasectomies. Maryland’s law covers over-the-counter emergency contraception, such as Plan B, and the state has acted to preserve funding for Planned Parenthood, another GOP target.
- Vermont Gov. Peter Shumlin (D) in May 2016 signed a bill requiring insurers to cover contraceptives, including vasectomies, without consumer cost sharing.
- California in 2014 enacted a law requiring insurers cover contraceptives without co-pay. A separate law in the state requires that insurers treat maternity coverage and abortion coverage in the same manner. And in 2016, lawmakers required all health plans to cover a 12-month supply of contraceptives.