Obamacare's Birth Control Coverage Explained in Six Questions

There’s been a lot of media coverage around the Affordable Care Act’s new rules on birth control. But if you’re still confused on how the healthcare law will affect your birth control options, I’m not surprised. There has been so much hubbub around lawsuits and complaints that it’s hard to figure out from the headlines whether birth control is supposed to be free or not. That’s why I did some research to break through the BS and lay out the details of how Obamacare will actually affect birth control coverage. 

Before we begin, I want to note why it’s important to understand the real life impacts of the Affordable Care Act, rather than just the political debates that threaten to consume it. A new Guttmacher Institute report shows that almost 13 million women of reproductive age were uninsured in 2012. That’s a lot of women who have to pay out of pocket for birth control, which is probably one of the reasons why women living below the federal poverty line are five times more likely to have an unintended pregnancy than women making far over the poverty line. Whether or not a woman becomes pregnant shouldn’t depend on her income. Obamacare is expanding birth control coverage to millions of women—but we have to know how the law works. 

Below are six simple questions about Obamacare and birth control, explained without the political noise. 

So wait, what is happening on October 1^st? Seems like something big. 

Remember way, way back in 2010 when Congress passed the Affordable Care Act? We’re finally seeing a big part of the law kick in. Starting October 1^st, people all over the country who have no insurance or have terrible insurance can start applying for public health insurance plans. The new coverage won’t actually start until January, though.

Is birth control covered by these new public plans?

It’s better than that—since 2012, all health insurance has been mandated to cover all the costs of birth control. So not only do the new public plans cover the cost of birth control, anyone with private insurance shouldn’t be shelling out a co-pay for birth control, either. Yay!

The only plans that do not currently cover birth control without co-pays are “grandfathered” plans: plans created before March 2010 (when the President signed the healthcare law) that haven’t made significant changes yet. Fortunately, these plans are required to make changes soon and eventually the distinction between the two plans will disappear. 

What kind of birth control is covered?

All of the kinds! Health insurance covers the cost of all of the different kinds of FDA-approved birth control and sterilization procedures, including long-term options like like IUDs and implants. This is great news because long-term birth control options are incredibly effective but the high upfront cost can keep them from being accessible to everyone. However, some insurance companies will not pay for the brand-name version of a birth control method if there is a generic version offered.

Insurance now also has to cover a lot of other reproductive healthcare needs, like HPV vaccines and breastfeeding supplies. Awesome! 

But what about people who work for religious groups? Does even, say, a Catholic college have to provide insurance that covers birth control?

Yeah, sorry about that. There was a lot of drama between Obama and religious employers over whether they would have to cover birth control. The verdict is that churches and other houses of worship can choose to exclude birth control coverage from the health insurance plans they offer their employees. But, under a recent and rather complicated ruling, insurance companies covering employees of religiously affiliated organizations (like a Catholic College or hospital) that object to birth control will cover birth control for employees from a separate account. So on your end as an employee of a Catholic college, your birth control should be covered without any co-pay.   

Also, some states have laws called “conscience clauses” that allow pharmacists to deny giving birth control to patients if they believe the medicine violates their religious beliefs, so some women could potentially have trouble filling prescriptions.  

Is Plan B covered?

The Affordable Care Act says that health insurance is only required to cover birth control that is prescribed by your doctor. Emergency contraception brand Plan B One-Step is now available over the counter to people of all ages, so if you buy it without a prescription, you’ll have to pay the full cost out of pocket.

However, if you get emergency contraception prescribed by a doctor your insurance will cover it without a co-pay. Most brands of emergency contraception are best when taken ASAP (except for ella), so the quicker access of getting it over-the-counter might outweigh the cost of getting it free.

This all sounds good, but what if my insurance actually refuses to cover the cost of birth control?

The National Women’s Law Center is fielding complaints about the system and has even set up a hotline (1-886-PILL4US) for women to call if they’re being denied birth control coverage. So far, the center says it has seen two recurring problems: doctors not knowing about the new changes and patients not being able to get the exact kind of birth control they want. For example, some people have reported that their insurance providers are telling them they can only get one kind of IUD, or that they can’t get methods of birth control that don’t have a generic option, like the Nuvaring or the Ortho Evra patch.

If this happens to you, don’t give up—insurance is legally required to cover any kind of birth control your doctor prescribes, so call the hotline and they’ll help you out.