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Biden Team Offers Stern Reminder on Contraceptive Coverage

July 28, 2022, 8:03 PM

The Biden administration issued guidance Thursday to reinforce Obamacare requirements that health plans cover contraceptive coverage at no cost to participants.

The Frequently Asked Questions guidance from the departments of Health and Human Services, Labor, and the Treasury follows an executive order issued by President Joseph Biden July 8 to bolster access to reproductive care following the Supreme Court overturning Roe v. Wade.

Secretary of Labor Marty Walsh said in a statement that there have been “troubling reports that plans and issuers are not following the law,” and he pledged that the administration “will take action to ensure that participants receive this coverage” with no cost sharing.

The guidance is part of a continuing stream of actions by the administration to try to ensure access to reproductive services. It follows an earlier meeting in June between HHS Secretary Xavier Becerra and Walsh with health insurers and employee benefit plan officials to reinforce that the plans must cover contraception without imposing cost-sharing under the ACA.

In a telephone press briefing, a DOL official, who spoke on the condition that she not be identified, said complaints have come in where individuals haven’t been able to access contraception that their doctor has recommended for them.

Health insurance plans are allowed to use “reasonable medical management, but they are not allowed to use medical management where a particular guideline specifies the frequency, the method, treatment or setting for the recommended preventive services,” the official said.

Insurers also can’t use medical management to require people to “use a different type of contraception” than what was recommended by their provider, the official said.

That sort of “inappropriate steering” would not be permitted, she said.

“Today’s guidance makes clear that the law requires group health plans and health insurance issuers to provide contraceptive coverage—including emergency contraception—at no cost to participants,” Walsh said in the statement.

Health plans must “remove impermissible barriers and ensure individuals have access to the contraceptive coverage they need,” Walsh said.

The HHS “will do everything we can to ensure that you have access to the full range of reproductive health care you need,” Chiquita Brooks-LaSure, administrator for the Centers for Medicare & Medicaid Services, said in the statement.

To contact the reporter on this story: Sara Hansard in Washington at shansard@bloomberglaw.com

To contact the editor responsible for this story: Brent Bierman at bbierman@bloomberglaw.com