Contraceptives and ACA

On Monday, August 1st, HHS released an amendment to the ACA preventive services regulations that focuses on women’s health issues. They have indicated that non-grandfathered health plans need to provide the following items at no cost-sharing to the patient:

• Well-woman visits
• Contraception
• Screening and counseling for AIDS, HPV, sexually transmitted infections, gestational diabetes and domestic violence
• Breastfeeding supplies and counseling

Plans provided by religious institutions can be granted a waiver of these requirements if they conflict with the religious beliefs of the employer.

The regulations also allow that if a generic equivalent is available, plans can apply copays and/or deductibles to non-generic supplies.

It’s difficult to estimate the financial impact of these changes until the marketplace develops a reaction, but it’s clear that the regulations, like any benefit mandate, will have an initial cost increase. Long-term, overall costs are expected to decrease as fewer unplanned pregnancies, early detection of adverse infections and domestic situations, as well healthier newborns should emerge as positive results.

It’s important to recognize these requirements are to be effective with plan years starting on or after August 2, 2012. Carriers and plan sponsors will need to adapt their systems and processes during the next year to accommodate these changes, but we shouldn’t expect a lot of details to materialize on these changes for the next few months. As these decisions are communicated to TrueNorth, we’ll be sure to keep you informed.

Let us know if you have any questions on this.

TrueNorth Benefits Team
319.364.5193