Obama contraception requirement takes effect for 200,000 Maine women

More than 200,000 women in Maine with private insurance will no longer pay out of pocket for some preventive health services, including birth control, under a provision of President Barack Obama’s health reform law that took effect Wednesday.

The provision includes a hotly debated requirement that employers include at no cost all forms of contraception approved by the Food and Drug Administration in health plans offered to workers. Religious groups have decried the requirement, saying it forces them to violate their beliefs against the use of contraception.

Less controversial are seven other mandated services for women, including breastfeeding supplies, screening and counseling for domestic violence and HIV, and preventive care such as pap smears.

“I think this is a huge step forward for Maine women, particularly when you think about how many women are struggling to pay their bills,” said Andrea Irwin of Consumers for Affordable Health Care, who also leads a coalition dedicated to better health for women and girls in Maine. “Many women end up forgoing preventive care like this because they can’t afford it.”

Health insurers must offer the preventive services for women without charging a deductible or copay. While the services will be free to individuals, health insurers will pick up the tab for any increase in women taking advantage of birth control and screenings.

“[The services] are in fact not free,” said Joel Allumbaugh, director of the center for health reform initiatives at the Maine Heritage Policy Center. “You are paying for them in your premiums.”

He estimated that the regulation will nudge health insurance rates up by about a third of a percent, as insurers spread the cost among all policyholders, including men. Many of the preventive health services for women were already covered by policies in Maine, with a copay or deductible, Allumbaugh said.

The Obama administration has argued that insurers will ultimately save money by preventing unwanted pregnancies.

The rules also require insurers to cover sterilization and prescriptions for emergency contraception, such as the so-called “morning-after pill,” at no cost.

While the regulation took effect Wednesday for new health plans, many women will still have to pay at the drugstore or their doctor’s office over the next few months. The provision kicks in for existing policies when they renew, which is Jan. 1, 2013 for many employer-based plans. Still other health plans that were in place before the Patient Protection and Affordable Care Act was enacted in March will be grandfathered, and won’t offer free birth control until 2014.

Irwin suggested that women contact their individual carriers to find out when preventive services will be offered at no cost.

The U.S. Department of Health and Human Services estimates that 47 million women aged 15 to 64, including 212,588 women in Maine, will benefit from the regulation. The figures don’t reflect that the proportion of grandfathered plans may vary state to state, that some women already have free coverage for preventive services, or that some employers are exempt from the requirement.

The Obama administration originally exempted only religious employers, such as churches and synagogues, from the mandate, but required universities, hospitals and other institutions with religious affiliations to comply. After a fierce backlash from the Catholic church, the White House softened its stance, giving employers with religious affiliations another year to abide while a compromise is brokered.

Several religious organizations have filed lawsuits against the provision. A federal judge ruled last week in favor of a Colorado business owned by a Catholic family who argued that the rules forced them to support contraception against their religious beliefs.

Another provision of the federal health reform law took effect Wednesday that requires insurance companies to refund millions of dollars to policyholders whose plans spent too much of their premium dollars on administrative costs instead of medical care. Maine residents who work for larger employers are expected to receive $2.6 million in rebates.