Proposed Rules for Contraceptive Services
Mar 21, 2023
The Affordable Care Act (ACA) requires non-grandfathered health plans to cover contraceptives in 18 FDA-defined categories with no cost sharing.聽 This mandate has a long and politically contentious history, resulting in numerous lawsuits and four appeals to the U.S. Supreme Court.
Even in light of Supreme Court cases in 2014 (Burwell v Hobby Lobby) and 2016 (Zubik v Burwell), only churches and their integrated auxiliaries were outright exempt from the mandate the first few years it was in effect.聽 Under the ACA, religious non-profits objecting to some or all of the mandate were required to navigate a formal accommodation process whereby they notify their insurer/TPA (or HHS) of the parts of the contraceptive mandate to which they object. Subsequently, the insurer/TPA could then provide the coverage by other means to affected employees.聽 Later in 2014, after the Hobby Lobby decision, closely held for profit employers gained access to the accommodation process as well.
Further, in 2018, the Trump administration issued rules that extended exemption to a much broader list of qualifying employers with sincerely held religious beliefs or moral convictions and made accommodation an optional process.聽 Those 2018 final rules have continued to this day, having been upheld 7-2 in the Supreme Court decision: Little Sisters of the Poor v Pennsylvania on July 8, 2020.
Most recently, federal regulators have a with new ideas and are accepting public comment through April 2, 2023.聽 A outlines the proposal, consisting of two major parts:
Employers interested in providing public comment can click the proposed rule link above.聽 We will keep employers informed when a final rule is issued.
IMA will continue to monitor regulator guidance and offer meaningful, practical, timely information. This material should not be considered as a substitute for legal, tax and/or actuarial advice. Contact the appropriate professional counsel for such matters. These materials are not exhaustive and are subject to possible changes in applicable laws, rules, and regulations and their interpretations.