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Insurers Dodge Obamacare Women's Health Mandates, Study Finds

By Melanie Zanona, CQ Roll Call

April 29, 2015 -- Some insurers are dodging women's health coverage requirements in Affordable Care Act, according to a new report, but advocates stopped short of calling for new laws to bring those health plans into compliance.

The National Women's Law Center (NWLC) recently said it found almost half of the plans it studied were in some way violating a provision in the health care overhaul requiring insurers to cover women's preventive services without cost sharing. The group examined the practices of 120 issuers across 15 states on such services as birth control, well-woman exams, or breastfeeding supports and supplies. 

The review found 14 plans were not covering maternity care and other health services for dependents, as required by law. One of the more popular provisions of the overhaul was allowing children to stay on their parents' insurance until they are 26.

"The promise of the ACA has not become a reality for all women in this country," said Gretchen Borchelt, the group's vice president for health reproductive rights, referring to the Affordable Care Act. "There is a range of violations as it relates to women's health coverage."

The health law also prohibits insurers from designing plans that discriminate based on age, sex, gender, or race. But NWLC found nearly 100 violations, from failure to provide coverage for transgender people to only covering prenatal medications for women under 42 and contraception for women under 50.

When it comes to the law's birth control mandate, the study found numerous instances of non-compliance, a trend supported by other recent reviews. Even though most private insurers must cover all Food and Drug Administration–approved forms of contraception at no cost, some plans were requiring a copayment, while others limited the methods they would cover.

"Any woman knows there is a big difference between taking the pill and getting an [intrauterine device]," said Sharon Levin, director of federal reproductive health policy for NWLC.

Some of the group's recommendations for bringing insurers into compliance include requiring more transparency from the plans during open enrollment and urging federal and state regulators to exhibit more oversight. The group also encourages consumers to work with advocates when they run into coverage barriers, because the organization said it has seen some success with insurers voluntarily changing their plans.

"We don't need federal legislation, there is already a federal law," Levin said. "We need administration action and regulation to make sure it's implemented correctly."

Washington Democrat Patty Murray, ranking member of the Senate Health, Education, Labor, and Pensions Committee and a champion of women's health issues, sent a letter earlier this week to certain insurance plans in her state over their failure to cover numerous forms of contraception and provide women with accurate information about the services available under the health law.

"I request an update in writing on your steps to correct these issues for women across Washington State immediately," she wrote.

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