Insurers in Massachusetts have to cover birth control without copay under new law

Massachusetts Gov. Charlie Baker signed a law on Nov. 21 to require insurers cover birth control products without copays, allow women to obtain a year’s supply at once and prevent most employers from opting out of contraceptive coverage on moral or religious grounds.

The law runs counter to actions by President Donald Trump, whose administration rolled back the ACA’s contraceptive mandate by allowing all employers to seek a religious or moral exemption. The Massachusetts Attorney General’s office sued over that rule change in October, with this new law limiting the exemption to churches and other religious institutions.

“We are proud to join our colleagues in the legislature to protect women’s healthcare and access to family planning services,” Mass. Gov. Charlie Baker said in a statement. “Massachusetts leads the country in healthcare with nearly universal coverage, and signing this important, bipartisan bill into law ensures critical access to contraceptive coverage for women across the Commonwealth.”

State lawmakers went beyond the ACA’s contraceptive mandate in terms of how many prescription birth control pills women can obtain. Under the law, insurers will have to pay for 12-month supply of pills after a three-month trial period. Supporters of the law said most customers are currently required to reorder the pills every one to three months.

Insurers will have to cover at least one version of every type of birth control which has been approved by the Food and Drug Administration, or one specified by a patient’s doctor, with no cost-sharing. This would include pills, emergency contraceptives and longer-lasting methods like an intrauterine device (IUD).

Copays would be allowed in limited circumstances, such as when a patient uses a brand name drug when a generic equivalent is available.

The state’s Center for Health Information and Analysis estimated earlier this month that the mandate would cause monthly insurance premiums to rise by 7 and 20 cents, while costing the health system up to $5.7 million per year over the next five years. Insurance groups, however, supported the bill.

“Blue Cross has a long history of working collaboratively to develop innovative, cost-effective solutions to challenges in healthcare delivery,” said Andrew Dreyfus, president and CEO of Blue Cross Blue Shield of Massachusetts. “We’re proud to support this legislation that once again establishes Massachusetts as a model for the rest of the country.”

Insurers in Massachusetts have six months to design plans that comply with the mandates.

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John Gregory, Senior Writer

John joined TriMed in 2016, focusing on healthcare policy and regulation. After graduating from Columbia College Chicago, he worked at FM News Chicago and Rivet News Radio, and worked on the state government and politics beat for the Illinois Radio Network. Outside of work, you may find him adding to his never-ending graphic novel collection.

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