With the controversy over copay-free coverage for contraception and other women’s reproductive health benefits still raging, the Obama administration is asking the public to weigh in on how to provide such coverage for all women without making not-for-profit religious employers pay for services they object to.
In an advanced notice of proposed rulemaking released March 16, the Department of Health and Human Services, the Department of Treasury, and the Department of Labor provided details on a compromise proposed by the president last month. At that time, President Obama said that the administration would find a way for women to receive copay-free contraceptive coverage without religious employers having to pay for that service.
The advanced notice of proposed rulemaking states that religious institutions that are not exempted from the contraception coverage requirement could have their health plan separately arrange for contraception to be provided, and the health plan would pay for its own.
But many critics said the idea would fall apart for institutions that were self-insured, meaning that they directly pay for health services for their employees instead of contracting with a separate health plan. In that case, the new notice proposes three options for allowing religious institutions to avoid the contraception issue.
The options include:
• Using a third-party administrator to fund contraception coverage by using revenue from drug rebates, service fees, and disease-management program fees.
• Diverting a portion of the money the administration pays under the Affordable Care Act’s reinsurance program.
• Contracting with a separate health plan that would provide contraception at no cost.
The government will accept comments on the rule for 90 days after its official publication date (March 21, 2012). Administration officials said they will consider those comments as they move forward with a final regulation.
The Obama administration also released a final regulation on March 16 governing how the requirements of the ACA apply to student health plans. Under the rule, students will have the same protections and benefits as people who purchase health plans on the individual market. When it comes to free coverage of contraception for student health plans affiliated with religious employers, they will be treated the same way as the institution’s employee health plans, according to an administration official. The regulation does not apply to self-funded student health plans.