How Will ACA Implementation Work? Tell Us!

Elisabeth Smith, LSRJ Summer Legal Intern

I’m sure you’ve heard the news. Starting August 1, 2012, the Affordable Care Act (ACA) requires all new health insurance plans to cover specific women’s preventive health services, including birth control, without a co-pay. This is great news–no co-pays will mean more women will receive critical care and some economic barriers to regular birth control use will be lifted.

Student health plans must comply with this requirement at the beginning of their new plan year (most student plans run from the beginning of the school year, e.g., August to August). The timing of student health insurance plans means that students will be among the first to have access to critical health services without a co-pay.

LSRJ and the National Women’s Law Center (NWLC) have teamed up to help students learn about the new coverage and investigate their school’s implementation.

Okay, question time:

What can students get without a co-pay?

Preventative services for women that must be covered without a co-pay include:

(1)   Contraceptive methods and counseling, including emergency contraception, as prescribed;

(2)  Well-woman visits;

(3)  Counseling regarding sexually transmitted infections including HIV;

(4)  Screening for HIV;

(5)  DNA co-testing for HPV;

(6)  Breastfeeding support, supplies, and counseling;

(7)  Screening and counseling for interpersonal and domestic violence; and

(8)  Screening for gestational diabetes.

Are there any student plans that do not have to comply?

  • Grandfathered health plans – those that existed before March 23, 2010, when the ACA was passed – do not have to comply with the preventive services requirement.  But it is unlikely that a student plan will be grandfathered. If a student first enrolled in the plan after March 23, 2010, then it should not be grandfathered.
  • Self-funded student health plans – those administered by colleges and universities without third party insurers – do not have to comply with the preventive services requirement. It is estimated that there are approximately 200,000 students covered through self-funded student health plan arrangements.

What kind of contraception is covered?

  • The full range of FDA-approved contraceptive methods as prescribed is included. This means a woman can access oral contraception (the pill), emergency contraception, injectables, the ring, contraceptive implants, diaphragms, cervical caps, and non-surgical permanent contraceptives without paying a co-payment or having the costs applied to her deductible.  Sterilization for women is also covered with no co-pay or deductible.

What about colleges and universities that object to covering contraception for students?

  • Colleges and universities with religious objections are not exempt from providing contraceptive coverage for their students. However, certain non-profit institutions of higher education with religious objections to covering contraception for students can obtain a one-year delay.
  • Qualifying schools are exempt from providing coverage only for contraception for one year; they still must provide coverage for the other women’s preventive health services.
  • These schools must notify students that they will not receive contraceptive coverage during this one year grace period.

How do I find out when my student plan starts and whether my school is requesting a one-year birth control delay?

  • Contact your student health insurance plan by calling the number on the back of your insurance card.
  • Ask when your new plan year starts.
  • If the answer is some time in 2013, say you will call back closer to that date.
  • If the answer is August or September, ask whether the plan will be covering women’s preventive services without a co-pay starting on that date.
  • If the answer is yes, celebrate.
  • If the answer is no, ask why
  • Let LSRJ and the NWLC know what you find out! Reporting back will affect nationwide implementation of the ACA requirements because you can alert us to problems or successes. Email info@lsrj.org & pill4us@nwlc.org

 

One Response to “How Will ACA Implementation Work? Tell Us!”

  1. Lana Says:

    are IUD’s covered? Looks like it was missing from the list of FDA approved contraceptives that are covered. Maybe I missed it!