Clinician Question: Now that the Affordable Care Act is in effect, can my patients get birth control without co-pays?

Good question! This is a complex issue. Here’s what the Affordable Care Act (ACA) means for birth control access.

Under the ACA: “Women will have access to all Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling [without cost-sharing].” (http://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html)

This is great news! However, even though this portion of the ACA took effect on August 1, 2012, exceptions persist. Until the law takes full effect in 2014, some people – including those in a grandfathered insurance plan and those with a religiously affiliated employer – may have a deductible or co-pay for contraception.

Grandfathered Plan: A plan that was established prior to or on March 23, 2010 and continuously covered at least one person from that day forward. Grandfathered plans may apply co-pays and deductibles to some preventive services (including birth control).

Religious Employers: Religiously-affiliated organizations such as hospitals, schools and charities/non-profits were granted an extra year to come into compliance with ACA mandates. Currently, these types of employers are not required to provide, pay for or refer employees for contraception.

While the ACA mandates access to all FDA-approved contraceptive options without co-pays, implementation of the law by insurance companies may vary. Coverage for IUDs and implants remains unclear. Nevertheless, the passing of the ACA is a key step towards increasing access to contraception. Starting in 2014, even grandfathered and religiously affiliated plans must cover contraception without any financial barriers.

The chart below details the increase in the number of women who now have access to preventive services without co-pays in the five states with the highest number of Contraceptive Pearl subscribers.

Increase in the number of women receiving preventive services due to ACA as of August 1,2012 (http://www.healthcare.gov/law/resources/index.html)

If you have questions or concerns about access to contraception under the ACA or more insight into its implementation, please email us and let us know! We will keep a close eye on this issue.

We appreciate your feedback! Please write us at pearls@reproductiveaccess.org with any questions, comments or additional resources to add to our list.

Helpful Resources

Your Birth Control Choices

Pharmacies with Low-Cost Birth Control Pills

Sources

http://www.healthcare.gov/law/full/

http://www.hrsa.gov/womensguidelines/#footnote2

http://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html

Pharma-free

The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.