Obamacare's Birth Control Coverage Explained in Six Questions

Birth control pills making a smiley face

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 1st? 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 1st, 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. 

the hotline number

by Hannah Strom
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8 Comments Have Been Posted

I'm thrilled that my packet

I'm thrilled that my packet of pills runs out a day after the 1st, it's going to be really nice to not be shelling out for my 'lady meds' as my boyfriend calls them (he's very sweet and splits the cost of my pills, since they were on the pricey side). One less monthly cost for me and other women trying to be responsible.

It says sterilizations

It says sterilizations procedures should be covered which is excellent as I've wanted to get that done forever. However, underneath is says Services that are not covered: Abortion and Services related to a man’s reproductive capacity, like vasectomies. Now I was very mad about this because it is extremely harmful to both men and women. Abortion for obvious reasons but the lack of coverage for male sterilization procedures as well. Men don't get coverage for something that is their choice and women are expected to take on the brunt of the STD prevention and pregnancy prevention AS ALWAYS. A good step but still sexist legislation.

One less monthly cost for me

One less monthly cost for me and other women trying to be responsible. Now we can be as irresponsible as possible, whoring with virtually everything that walks by us since our pimps, sorry, taxpayers, will be footing the bill. How liberating.

Sex takes two buddy, so why

Sex takes two buddy, so why are you only attacking the "whores" and not the "Johns?" Okay well maybe sex for you only involves one person...

Thanks for the clarification

Thanks for the clarification - excited to share this bit with my friends!

Just a note on Plan B from my personal experience: my birth control has been fully covered by insurance since January and when doing a bit if research on the United Healthcare website, I discovered Plan B was also covered when prescribed. I took this information to my doctor during my annual exam and asked her to prescribe a pack should an emergency arrive and she did! This obviously isn't doable in every situation, but could help save costs down the road. I've also had a friend contact her doctor and ask her to call in a prescription, which also worked in getting the pill covered! It took some explaining of why, but if your doctor is rad, it's worth a try!

Great article! I work in

Great article! I work in women's health and many clinics and patients don't understand the ACA. There continues to be misperceptions about cost and coverage so the uptake of highly effective contraception hasn't changed much. More needs to be done to help the providers and clinics educate themselves and their patients in order to reduce Unintended pregnancies.

The one bit of BC info that everyone seems to leave out

I've yet to see any articles mention deductibles and how birth control will work under the Affordable Care Act, and it's important -If you have a high deductible plan, you will STILL have to meet your deductible before your birth control will be fully covered by your plan.

I called my insurance provider specifically to ask how this would work. I currently have a high deductible plan - it's $2000 to be exact. Only AFTER I've met my deductible, as in, shelled out $2k of my own cash in healthcare costs, will my BC be covered. Being someone who generally only sees a doctor once or twice a year and only takes one prescription (at $85 per month for my pills) that has literally never happened. Unless I switch to a different plan when the exchanges open, my insurance will STILL never have to pay for my birth control.

womens bodies battleground

In the retro world of Republicans, women still take a back seat when it comes to controlling their own bodies.Without any safety precautions its a dangerous ride indeed.Does it matter who's at the wheel...you betchum. Take a look http://wp.me/p2qifI-1JC

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