Women Still Paying for Contraceptives

Senator Bernie Sanders of Vermont has urged a government watchdog to investigate why women are still paying for birth control despite federal laws mandating free access. The Affordable Care Act (ACA) requires private insurance plans to cover the "full range" of FDA-approved contraceptives, including related services, without co-payments or deductibles. This mandate aims to ensure comprehensive reproductive health coverage for women.

However, a recent survey by KFF, a nonprofit health policy research organization, revealed that around 25% of women with private insurance still pay some costs for their birth control. This includes 16% who reported partial coverage and 6% who stated their plans did not cover contraceptives at all. A 2022 congressional investigation found that insurance companies often deny exception requests for contraceptive coverage, with an average denial rate of 40%.

Insurance companies' non-compliance is partly due to infrequent enforcement and low penalties. Anna Bahr, communications director for Senator Sanders, noted that companies often find new ways to deny coverage even after being penalized. Instances include insurers not covering certain contraceptives like hormonal rings or IUDs, citing coverage of another hormonal method, which violates the ACA mandate.

Gretchen Borchelt, vice president of reproductive rights and health at the National Women’s Law Center, reported that some insurance plans now employ a "try and fail" approach. This requires patients to try specific contraceptives, typically oral pills, until they fail before the desired method is covered. This practice has been deemed "problematic" by the Department of Labor.

Additionally, insurers frequently deny coverage for newer FDA-approved contraceptives and associated services like IUD insertion or removal. Alina Salganicoff, senior vice president for women's health policy at KFF, indicated that the percentage of women paying nothing for IUDs or implants has declined since 2015.

If charged for contraception, women should consult both their doctors and insurance companies, citing the law that mandates free coverage. The National Women’s Law Center hotline can help review plans and seek reimbursements. Public pressure and complaints to representatives can also prompt investigations and corrective actions, as seen in Vermont, where insurers were ordered to issue $1.5 million in reimbursements after a two-year investigation found wrongful charges for contraceptives.