New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women


You can read the original article here.

Source:

Sobel L., Salganicoff A., Rosenzweig C. (6 October 2017). "New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women" [Web Blog Post]. Retrieved from address https://www.kff.org/womens-health-policy/issue-brief/new-regulations-broadening-employer-exemptions-to-contraceptive-coverage-impact-on-women/

The Trump Administration has issued new regulations that significantly broaden employers’ ability to be exempt from the Affordable Care Act’s (ACA) contraceptive coverage requirement.  The regulation opens the door for any employer or college/ university with a student health plan with objections to contraceptive coverage based on religious beliefs to qualify for an exemption. Any nonprofit or closely-held for-profit employer with moral objections to contraceptive coverage also qualifies for an exemption. Their female employees, dependents and students will no longer be entitled to coverage for the full range of FDA approved contraceptives at no cost.

On October 6, 2017, the Trump Administration issued two new regulations greatly expanding the types of employers that may be exempt from the Affordable Care Act’s (ACA) contraceptive coverage requirement.  These regulations are a significant departure from the Obama-era regulations that only granted an exception to houses of worship.  One of the regulations allows nonprofits or for-profit employer with an objection to contraceptive coverage based on religious beliefs to qualify for an exemption and drop contraceptive coverage from their plans.  The other regulation also exempts all but publicly traded employers with moral objections to contraception from rule. These new policies, effective immediately, also apply to private institutions of higher education that issue student health plans. The immediate impact of these regulations on the number of women who are eligible for contraceptive coverage is unknown, but the new regulations open the door for many more employers to withhold contraceptive coverage from their plans.

New regulations from the Trump administration greatly expand exemption from #ACA contraceptive coverage rule

Contraceptive coverage under the ACA has made access to the full range of contraceptive methods affordable to millions of women. This provision is part of a set of key preventive services that has been identified by the Health Resources and Services Administration (HRSA) for women that must be covered without cost-sharing. Since it was first issued in 2012, the contraceptive coverage provision has been controversial. While very popular with the public, with over 77% of women and 64% of men reporting support for no-cost contraceptive coverage, it has been the focus of litigation brought by religious employers, with two cases (Zubik v Burwell and Burwell v Hobby Lobby)  reaching the Supreme Court. This brief explains the contraceptive coverage rule under the ACA, the impact it has had on coverage, and how the new regulations issued by the Trump Administration change the contraceptive coverage requirement for employers and affect women’s coverage.

How do the new regulations change contraceptive coverage requirements for employers?

Since they were announced in 2011, the contraceptive coverage rules have evolved through litigation and new regulations. Most employers were required to include the coverage in their plans. Houses of worship could choose to be exempt from the requirement if they had religious objections. This exception meant that women workers and female dependents of exempt employers did not have guaranteed coverage for either some or all FDA approved contraceptive methods if their employer had an objection. Religiously affiliated nonprofits and closely held for-profit corporations were not eligible for an exemption, but could choose an accommodation. This option was offered to religiously affiliated nonprofit employers and then extended to closely held for-profitsafter the Supreme Court ruling in Burwell v. Hobby Lobby. The accommodation allowed these employers to opt out of providing and paying for contraceptive coverage in their plans by either notifying their insurer, third party administrator, or the federal government of their objection. The insurers were then responsible for covering the costs of contraception, which assured that their workers and dependents had contraceptive coverage while relieving the employers of the requirement to pay for it.

As of 2015, 10% of nonprofits with 5,000 or more employees had elected for an accommodation without challenging the requirement. This approach, however, has not been acceptable to all nonprofits with religious objections.1 In May 2016, the Supreme Court remanded Zubik v. Burwell, sending seven cases brought by religious nonprofits objecting to the contraceptive coverage accommodation back to the respective district Courts of Appeal. The Supreme Court instructed the parties to work together to “arrive at an approach going forward that accommodates petitioners’ religious exercise while at the same time ensuring that women covered by petitioners’ health plans receive full and equal health coverage, including contraceptive coverage.”2

On October 6, 2017, the Trump Administration issued new regulations greatly expanding eligibility for the exemption to all nonprofit and closely-held for-profit employers with objections to contraceptive coverage based on religious beliefs or moral convictions, including private institutions of higher education that issue student health plans (Figure 1).  In addition, publicly traded for-profit companies with objections based on religious beliefs also qualify for an exemption. There is no guaranteed right of contraceptive coverage for their female employees and dependents or students. Table 1 presents the changes to the contraceptive coverage rule from the Obama Administration in the new Interim Final regulations issued by the Trump Administration.

Figure 1: Employers Objecting to Contraceptive Coverage: Exemptions and Accommodations Under the Trump Administration Regulations

The accommodation will be available to employers that previously qualified for the accommodation.  They now will also have the choice of an exemption. The federal departments issuing the regulations posit that these new rules will have limited impact on the number of women losing contraceptive coverage.   However, it is not clear how many employers previously utilizing the accommodation will now opt for an exemption, resulting in the loss of contraceptive coverage for their employees and dependents.  In addition, there are also an unknown number of organizations that were not previously eligible for either the accommodation or exemption that may now opt for an exemption. These new regulations create two new categories of employers who can now qualify for an exemption or can voluntarily chooses an accommodation:  1) publicly traded for-profit companies with a religious objection and 2) nonprofit and closely held for-profit employers who have a moral objection to contraceptives, a considerably larger pool of employers than when the exemption was available only to those who were employees of a house of worship or who were eligible for an accommodation in the past.

Table 1: Summary of Changes in the Contraceptive Coverage Regulations for Objecting Entities
  Obama Administration
August 2012 to October 5, 2017
Trump Administration
Effective October 6, 2017
What types of contraceptives must plans cover without cost-sharing? At least one of each of the 18 FDA approved contraceptive methods for women, as prescribed, along with counseling and related services must be covered without cost-sharing. No change
Are any employers “exempt” from the contraceptive mandate?
  • Religious institutions defined as “houses of worship”
  • Grandfathered plans
  • No notice to employees is required. Women workers and female dependents must pay for their own contraceptives.
  • Religious institutions defined as “houses of worship”
  • Grandfathered plans
  • Nonprofit or  for-profit employers (including publicly traded companies), insurers, or private colleges or universities that issue student insurance plans with a religious objection to contraceptive coverage
  • Nonprofit or closely held for-profit employers, insurers, or private colleges or universities that issue student insurance plans with a moralobjection to contraceptive coverage
  • Notice is only required if the plan previously included contraceptive coverage. Women workers and female dependents must pay for their own contraceptives.
Who pays for contraceptive coverage for employees of organizations receiving an exemption?
  • The cost of contraceptives is borne by women workers and female dependents.
  • There is no guarantee of contraceptive coverage for employees of an exempt organization.
  • The employer may choose to cover some methods, but has no obligation to cover all 18 FDA methods without cost sharing
No change

What type of employers may seek an “accommodation” to avoid paying for contraceptives in their plans?  
  • Closely held for-profit corporations and religiously affiliated nonprofits with religious objections to contraception can opt out of providing and paying for contraceptive coverage
  • Notice must be provided to either their insurer, third party administrator, or the federal government of their objection.
  • Women workers and female dependents receive no cost contraceptive coverage.
  • Any entity (except for houses of worship) eligible for an exemption can choose the accommodation instead of the exemption.
  • Notice must be provided to either their insurer, third party administrator, or the federal government of their objection.
  • Women workers and female dependents receive no cost contraceptive coverage.
Who pays for contraceptive coverage for employees of organizations receiving an accommodation?
  • Insurance companies of firms obtaining an accommodation must pay for contraceptive coverage.
  • Third-party administrators (TPA) of self-funded health plans must cover the costs of contraceptives for employees. The costs of the benefit are offset by reductions in the fees the TPA pays to participate in the federal exchange.
No change
When can entities change from an accommodation to an exemption? N/A
  • When an employer or private college or university currently using the accommodation opts for an exemption, the revocation of contraceptive coverage will be effective on the first day of the first plan year that begins 30 days after the date of the revocation or 60 days notice may be given in a summary of benefits statement.
  • The issuer or third party administrator is responsible for providing the notice to the beneficiaries.

How has the contraceptive coverage rule affected women?

Contraceptive use among women is widespread, with over 99% of sexually-active women using at least one method at some point during their lifetime.3 Contraceptives make up an estimated 30-44% of out-of-pocket health care spending for women.4 Since the implementation of the ACA, out-of-pocket spending on prescription drugs has decreased dramatically (Figure 2). The majority of this decline (63%) can be attributed to the drop in out-of-pocket expenses on the oral contraceptive pill for women.5 One study estimates that roughly $1.4 billion dollars per year in out-of-pocket savings on the pill resulted from the ACA’s contraceptive mandate.6  By 2013, most women had no out-of-pocket costs for their contraception, as median expenses for most contraceptive methods, including the IUD and the pill, dropped to zero.7

Figure 2: The Contraceptive Coverage Policy Has Had a Large Impact on Out-Of-Pocket Spending in a Short Amount of Time

This provision has also influenced the decisions women make in their choice of method. After implementation of the ACA contraceptive coverage requirement, women were more likely to choose any method of prescription contraceptive, with a shift towards more effective long-term methods.8  High upfront costs of long-acting methods, such as the IUD and implant, had been a barrier to women who might otherwise prefer these more effective methods.  When faced with no cost-sharing, women choose these methods more often9, with significant implications for the rate of unintended pregnancy and associated costs of childbirth.10

Finally, decreases in cost-sharing were associated with better adherence and more consistent use of the pill. This was especially true among users of generic pills.  One study showed that even copayments as low as $6 were associated with higher levels of discontinuation and non-adherence,11 increasing the risk of unintended pregnancy.

Do states with no-cost contraceptive coverage laws allow exemptions to objecting entities?

The federal standards under Affordable Care Act created a minimum set of preventive benefits that applied to most health plans regulated by the federal government (self-funded plans, federal employee plans) and states (individual, small and large group plans), including contraceptive coverage for women with no cost-sharing.  States have also historically regulated insurance, and many have had mandated minimum benefits for decades. State laws, however, have more limited reach in that they only apply to state regulated fully insured plans, do not have jurisdiction over self-funded plans, where 61% of covered workers are insured.12 In self-funded plans, the employer assumes the risk of providing covered services and usually contracts with a third party administrator (TPA) to manage the claims payment process. These plans are overseen by the Federal Department of Labor under the Employer Retirement Income Security Act (ERISA) and are only subject to federally established regulations.13  The ACA sets a minimum standard of coverage for preventive services for all plans. However, state laws regulating insurance, including contraceptive coverage, can require fully insured plans to provide coverage beyond the federal standards.

Eight states have strengthened and expanded the federal contraceptive coverage requirement (CA, IL, MD, ME, NV, NY, OR, VT).  Another 20 states have contraceptive equity laws that require plans to cover contraceptives if they also provide coverage for prescription drugs but they do not necessarily require coverage of all FDA-approved contraceptives or ban cost-sharing (Figure 3).

Figure 3: Many States Have Contraceptive Coverage Requirements

Many of the 28 states that have passed contraceptive coverage laws (both equity and no-cost coverage) have a provision for exemptions, but the laws vary from state to state and only apply to fully insured plans.  This means that there may be a conflict between the state and federal requirements when it comes to religious exemptions.  In some states with a contraceptive coverage requirement, some employers who are eligible for an exemption under federal law will not qualify for an exemption under state law (Table 2). Employers in those states will have to have to meet the standards established by their state even though they may qualify for an exemption based on the new federal regulations.  This conflict may set the stage for future litigation.

Table 2: State Requirements for No-Cost Contraceptive Coverage
StateDate Effective Applies to Coverage required without cost sharing Exemptions allowed
  Private plans Medicaid With RX all FDA approved OTC Vasectomy Religious Moral
CaliforniaJanuary 2015 X MCOs X Narrowly defined nonprofit religious employers None
IllinoisJanuary 2017 X X X
except male condoms
Any employer, or insurer with a religious objection Any employer, or insurer with a moral objection
MarylandJanuary 2018 X X X X X Religious organizations if the coverage conflicts with the organization’s bona fide religious beliefs and practices None
MaineJanuary 2019 X X Narrowly defined nonprofit religious employers None
NevadaJanuary 2018 X X X Insurers affiliated with a religious organization None
New YorkAugust 2017 X X Narrowly defined nonprofit religious employers* None
OregonAugust 2017 X X X Narrowly defined nonprofit religious employers None
VermontOctober 2016 X X – and all other public health assistance programs X X None None
NOTES: *Requires the insurer to offer a rider to policyholders so that women will have contraceptive coverage.
SOURCE: Kaiser Family Foundation analysis of state laws and regulations.

Conclusion

The Trump Administration’s new regulations substantially expand the exemption to nonprofit and for-profit employers, as well as to private colleges or universities with religious or moral objections to contraceptive coverage. It is unknown how many of these employers and colleges will maintain coverage through the accommodation as before and how many will now opt for the exemption leaving their students, employees and dependents without no-cost coverage for the full range of contraceptive methods. As a result of the new regulation, choices about coverage and cost-sharing will be made by employers and private colleges and universities that issue student plans. For many women, their employers will determine whether they have no-cost coverage to the full range of FDA approved methods.  Their choice of contraceptive methods may again be limited by cost, placing some of the most effective yet costly methods out of financial reach.

You can read the original article here.

Source:

Sobel L., Salganicoff A., Rosenzweig C. (6 October 2017). "New Regulations Broadening Employer Exemptions to Contraceptive Coverage: Impact on Women" [Web Blog Post]. Retrieved from address https://www.kff.org/womens-health-policy/issue-brief/new-regulations-broadening-employer-exemptions-to-contraceptive-coverage-impact-on-women/


Analysis: Before ACA Benefits Rules, Care for Maternity, Mental Health, Substance Abuse Most Often Uncovered by Non-Group Health Plans

What would happen to the non-group insurance market under the American Health Care Act (AHCA)? Read this article from the Kaiser Family Foundation to learn more.

Three in four health plans in the non-group insurance market did not cover delivery and inpatient maternity care in 2013, before the Affordable Care Act (ACA) essential health benefits requirement took effect, finds a new Kaiser Family Foundation analysis.

Other major benefits most often left uncovered before the ACA include substance abuse disorder services (inpatient and outpatient services each not covered by 45% of 2013 non-group plans) and mental/behavioral health services (inpatient and outpatient services each uncovered by 38% of the plans).

Additionally, some plans that covered maternity, substance abuse or mental health care services included meaningful limits or restrictions, the analysis finds.

Since 2014, the ACA has required non-group plans to cover 10 categories of essential health benefits comparable to those offered in employer group plans. The new analysis offers a window into how insurers could respond if the essential health benefits requirement is rolled back, a change being considered by Congressional leaders and allowed through state waivers by the House-passed American Health Care Act as a potential way for lowering premiums.

Without the requirement, however, insurers in the non-group market would likely be reluctant to offer coverage for some expensive services that have an element of predictability and persistence, as people who needed these benefits would disproportionately select policies covering them. Unlike in the pre-ACA market, insurers would not be able to exclude from coverage altogether people with pre-existing conditions.

The new analysis finds that all 2013 non-group plans covered basic benefits, such as inpatient hospital services, inpatient physician and surgical services, and emergency room services. Some plans didn’t provide various levels of prescription drug coverage, however.

The analysis uses data insurers provided for the Health Plan Finder on HealthCare.gov for the last quarter of 2013.  Certain provisions of the ACA, such as the prohibition of annual and lifetime dollar limits on benefits, had already begun to be phased in by that point, so the data does not reflect all of the types of limitations in non-group policies prior to the ACA.

See original article Here.

Source:

(14 June 2017) Analysis: Before ACA Benefits Rules, Care for Maternity, Mental Health, Substance Abuse, Most Often Uncovered by Non-Group Health Plans. [Web Blog Post]. Retrieved from address http://www.kff.org/health-reform/press-release/analysis-before-aca-benefits-rules-care-for-maternity-mental-health-substance-abuse-most-often-uncovered-by-non-group-health-plans/


Senate Health Bill Would Revamp Medicaid, Alter ACA Guarantees, Cut Premium Support

The Senate has just released their version of the American Health Care Act (AHCA).  Here is a great article by Julie Rovner from Kaiser Health News detailing what the Senate's version of the AHCA legislation means for Americans.

Republicans in the U.S. Senate on Thursday unveiled a bill that would dramatically transform the nation’s Medicaid program, make significant changes to the federal health law’s tax credits that help lower-income people buy insurance and allow states to water down changes to some of the law’s coverage guarantees.

The bill also repeals the tax mechanism that funded the Affordable Care Act’s benefits, resulting in hundreds of billions of dollars in tax cuts for the wealthy and health care industry.

Most senators got their first look at the bill as it was released Thursday morning. It had been crafted in secret over the past several weeks. Senate Majority Leader Mitch McConnell (R-Ky.) is seeking a vote on the bill before Congress leaves next week for its Fourth of July recess.

Senators had promised that their ACA replacement would be very different than the version that passed the House in May, but the bill instead follows the House’s lead in many ways.

At lightning speed and with a little over a week for wider review, the Republicans’ bill could influence health care and health insurance of every American. Reversing course on some of the more popular provisions of the Affordable Care Act, it threatens to leave tens of millions of lower-income Americans without insurance and those with chronic or expensive medical conditions once again financially vulnerable.

Like the House measure, the Senate bill, which is being called a “discussion draft,” would not completely repeal the ACA but would roll back many of the law’s key provisions. Both bills would also — for the first time — cap federal funding for the Medicaid program, which covers more than 70 million low-income Americans. Since its inception in 1965, the federal government has matched state spending for Medicaid. The new bill would shift much of that burden back to states.

The bill would also reconfigure how Americans with slightly higher incomes who don’t qualify for Medicaid would get tax credits to help pay insurance premiums, eliminate penalties for those who fail to obtain insurance and employers who fail to provide it, and make it easier for states to waive consumer protections in the ACA that require insurance companies to charge the same premiums to sick and healthy people and to provide a specific set of benefits.

“We agreed on the need to free Americans from Obamacare’s mandates, and policies contained in the discussion draft will repeal the individual mandate so Americans are no longer forced to buy insurance they don’t need or can’t afford; will repeal the employer mandate so Americans no longer see their hours and take-home pay cut by employers because of it,” McConnell said on the floor of the Senate after releasing the bill. He also noted that the bill would help “stabilize the insurance markets that are collapsing under Obamacare as well.”

It is not clear that the bill will make it through the Senate, however, or that all of it will even make it to the Senate floor. The Senate (like the House) is operating under a special set of budget rules that allow it to pass this measure with only a simple majority vote and block Democrats from dragging out the debate by using a filibuster. But the “budget reconciliation” process comes with strict rules, including the requirement that every provision of the bill primarily impact the federal budget, either adding to or subtracting from federal spending.

For example, the legislation as released includes a one-year ban on Medicaid funding for Planned Parenthood. That is a key demand of anti-abortion groups and some congressional conservatives, because Planned Parenthood performs abortions with non-federal funding. But it is not yet clear that the Senate parliamentarian will allow that provision to be included in the bill.

Also still in question is a provision of the Senate bill that would allow states to waive insurance regulations in the Affordable Care Act. Many budget experts say that runs afoul of Senate budget rules because the federal funding impact is “merely incidental” to the policy.

Drafting the Senate bill has been a delicate dance for McConnell. With only 52 Republicans in the chamber and Democrats united in opposition to the unraveling of the health law, McConnell can afford to lose only two votes and still pass the bill with a tie-breaking vote from Vice President Mike Pence. McConnell has been leading a small working group of senators — all men — but even some of those have complained they were not able to take part in much of the shaping of the measure, which seems to have been largely written by McConnell’s own staff.

So far, McConnell has been fielding complaints from the more moderate and more conservative wings of his party. And the draft that has emerged appears to try to placate both.

For example, as sought by moderates, the bill would phase down the Medicaid expansion from 2020 to 2024, somewhat more slowly than the House bill does. But it would still end eventually. The Senate bill also departs from the House bill’s flat tax credits to help pay for insurance, which would have added thousands of dollars to the premiums of poorer and older people not yet eligible for Medicare.

A Congressional Budget Office report estimating the Senate bill’s impact on individuals and the federal budget is expected early next week. The House bill, according to the CBO, would result in 23 million fewer Americans having health insurance over 10 years.

For conservatives, however, the Senate bill would clamp down even harder on Medicaid in later years. The cap imposed by the House would grow more slowly than Medicaid spending has, but the Senate’s cap would grow even more slowly than the House’s. That would leave states with few options, other than raising taxes, cutting eligibility, or cutting benefits in order to maintain their programs.

Defenders of the health law were quick to react.

Sen. Ron Wyden (D-Ore.) complained about changes to coverage guarantees in the ACA.

“I also want to make special note of the state waiver provision. Republicans have twisted and abused a part of the Affordable Care Act I wrote to promote state innovation, and they’re using it to give insurance companies the power to run roughshod over individuals,” he said in a statement issued shortly after the bill was released. “This amounts to hiding an attack on basic health care guarantees behind state waivers, and I will fight it at every turn.”

“The heartless Senate health care repeal bill makes health care worse for everyone — it raises costs, cuts coverage, weakens protections and cuts even more from Medicaid than the mean House bill,” said a statement from Protect Our Care, an umbrella advocacy group opposing GOP changes to the health law. “They wrote their plan in secret and are rushing forward with a vote next week because they know how much harm their bill does to millions of people.”

See the original article Here.

Source:

Rovner J. (2017 June 22). Senate health bill would revamp medicaid, alter ACA guarantees, cut premium support [Web blog post]. Retrieved from address http://khn.org/news/senate-health-bill-would-revamp-medicaid-alter-aca-guarantees-cut-premium-support/


Here's What The GOP Bill Would (And Wouldn't) Change About Women's Health Care

What will change about women's healthcare and what will stay the same? Danielle Kurtzleben explores the potential changes in the following article for NPR.

The Affordable Care Act changed women's health care in some big ways: It stopped insurance companies from charging women extra, forced insurers to cover maternity care and contraceptives and allowed many women to get those contraceptives (as well as a variety of preventive services, like Pap smears and mammograms) at zero cost.

Now Republicans have the opportunity to repeal that law, also known as Obamacare. But that doesn't mean all those things will go away. In fact, many will remain.

Confused? Here's a rundown of how this bill would change some women-specific areas of health care, what it wouldn't change, and what we don't know so far.

What would change:

Abortion coverage

There are restrictions on abortion under current law — the Hyde Amendment prohibits federal subsidies from being spent on abortions, except in the case of pregnancies that are the result of rape or incest or that threaten the life of the mother. So while health care plans can cover abortions, those being paid for with subsidies "must follow particular administrative requirements to ensure that no federal funds go toward abortion," as the Guttmacher Institute, which supports abortion rights, explains.

But the GOP bill tightens this. It says that the tax credits at the center of the plan cannot be spent at all on any health care plan that covers abortion (aside from the Hyde Amendment's exceptions).

So while health care plans can cover abortion, very few people may be able to purchase those sorts of plans, as they wouldn't be able to use their tax credits on them. That could make it much more expensive and difficult to obtain an abortion under this law than under current law.

Planned Parenthood funding

This bill partially "defunds" Planned Parenthood, meaning it would cut back on the federal funding that can be used for services at the clinics. Fully 43 percent of Planned Parenthood's revenue in fiscal year 2015 — more than $550 million — came from government grants and reimbursements.

Right now, under Obamacare, federal funds can be spent at Planned Parenthood, but they can't be used for abortion — again, a result of the Hyde Amendment and again, with the three Hyde Amendment exceptions. But this bill goes further, saying that people couldn't use Medicaid at Planned Parenthood.

To be clear, it's not that there's a funding stream going directly from the government to Planned Parenthood that Congress can just turn off. Rather, the program reimburses Planned Parenthood for the care it provides to Medicaid recipients. So this bill would mean that Medicaid recipients who currently receive care at an organization that provides abortions would have to find a new provider (whom Medicaid would then reimburse).

Abortion is a small part of what Planned Parenthood does: The organizations says it accounted for 3.4 percent of all services provided in the year ending in September 2014. (Of course, some patients receive more than one service; Planned Parenthood had around 2.5 million patients in that year. Assuming one abortion per patient, that's roughly 13 percent of all patients receiving abortions.)

Together, providing contraception and the testing for and treatment of sexually transmitted diseases made up three-quarters of the services the organization provided in one year.

That means low-income women (that is, women on Medicaid) could be among the most heavily affected by this bill, as it may force them to find other providers for reproductive health services.

Of the other government money that goes to Planned Parenthood, most of it comes from Title X. That federal program, created under President Richard Nixon, provides family planning services to people beyond Medicaid, like low-income women who are not Medicaid-eligible. Earlier this year, Republicans started the process of stripping that funding.

What wouldn't change (yet):

Republicans have stressed that this bill was just one of three parts, so it's hard to say definitively what wouldn't change at all as a result of their plan. But thus far, here's what is holding steady:

Maternity and contraceptive coverage

Because this was a reconciliation bill, it could cover fiscal-related topics only. It couldn't get into many of the particulars of what people's coverage will look like, meaning some things won't change.

The essential health benefits set out in Obamacare — a list of 10 types of services that all plans must cover — do not change for other policies. Maternity care is included in those benefits, as is contraception, so plans will have to continue to cover those. The GOP bill also doesn't change the Obamacare policy that gave women access to free contraception, as Vox's Emily Crockett reported.

In addition, maternity and contraception are still both "mandatory benefits" under Medicaid. That doesn't change in the GOP bill. (Confusingly, the bill does sunset essential health benefits for Medicaid recipients. But because there is overlap and these particular benefits remain "mandatory," they aren't going away.)

However, all of this won't necessarily remain unchanged. In response to a question about defunding Planned Parenthood this week, Health and Human Services Secretary Tom Price said that he didn't want to "violate anybody's conscience." When a reporter asked how this relates to birth control, Price did not give a definite answer.

"We're working through all of those issues," he said. "As you know, many of those were through the rule-making process, and we're working through that. So that's not a part of this piece of legislation right here."

So this is something that could easily change in the second "phase" of the health care plan, when rules are changed.

"Preventative services [the category that includes contraception] hasn't been touched, but we expect those to be touched probably via regulation," said Laurie Sobel, associate director for women's health policy at the Kaiser Family Foundation.

The end of gender rating

Prior to Obamacare, women were often charged more for the same health plans as men. The rationale was that women tend to use more health care services than men.

However, Obamacare banned the practice, and that ban seems unlikely to change, as the GOP cites nondiscrimination as one of the bill's selling points:

"Our proposal specifically prohibits any gender discrimination. Women will have equal access to the same affordable, quality health care options as men do under our proposal."

See original article Here.

Source:

Kurtzleben, D. (10 March 2017). Here's What The GOP Bill Would (And Wouldn't) Change About Women's Health Care. [Web Blog Post] Retrieved from address http://www.npr.org/2017/03/10/519461271/heres-what-the-gop-bill-would-and-wouldnt-change-for-womens-healthcare