Dive Brief:
- The administration released new guidance this week that clarifies the Affordable Care Act's mandates for birth control coverage, stating that insurers must cover at least one form of each FDA-approved method of birth control without any cost-sharing.
- The administration also addressed transgender care, saying that insurers may not limit preventive services based on a patient's birth or previously recorded gender, and that they should cover the services recommended by that patient's provider—such as mammograms for a transgender woman.
- The guidance comes on the heels of reports released last month by the National Women's Law Center and the Kaiser Family Foundation that detailed birth control coverage limitations and failures to comply with non-discrimination provisions in the ACA.
Dive Insight:
The new guidance addresses coverage decisions that had previously been deemed open to interpretation under medical management, as AHIP previously maintained. Now it is clear that last month's reports are having an impact, and quickly—insurers are directed to comply with the clarified policy within 60 days.
"The Affordable Care Act was a major step forward in helping women get the healthcare services they need to stay healthy," Health and Human Services Secretary Sylvia Mathews Burwell said in a prepared statement. "Tens of millions of women are eligible to receive coverage of recommended preventive services without having to pay a co-pay or deductible, including contraception. Today, we are clarifying these coverage requirements."