I’ve avoided getting into debates because it’s a more complicated field than either side is allowing, but could somebody please get me started with objective info on what is required and of whom it is required?
Does the FedGov only require employers who receive state funds to offer insurance policies that pay for contraception?
Does a policy that does not cover contraception significantly less expensive to the company? (Not that I think any company is doing it for cost cutting reasons, but just curious.)
If Woman A takes a medication for contraception purposes, and Woman B takes the exact same medication (whether it’s the same or different brand name) for non contraception purposes, is it coded differently at all?
I ask these things because I’m guessing I’m not the only person who is trying to better understand the details of this debate, so any informative input appreciated.
PLEASE DO NOT STATE OPINION AS FACT AS THIS ISN’T A DEBATE BUT A QUEST FOR INFO. (It’s really more GQ, but if it gains any traction I know it won’t stay GQ.)
The original proposed mandate required insurance plans to pay for any FDA-approved contraception without copay. In response to comments, they added an exception to 45 CFR Section 147.130 (45 CFR 147 – HEALTH INSURANCE REFORM REQUIREMENTS FOR THE GROUP AND INDIVIDUAL HEALTH INSURANCE MARKETS) for religious employers:
The current foofaraw is over this definition; the Catholic Church, most prominently, employs non-Catholics, serves non-Catholics, and has a big problem with contraception. Other religious organizations are queasy about uncontrolled access to contraception, or some forms of contraception. They all want this waiver for their less strictly-church-related operations.
As to your questions: From 45 CFR:
So no, it’s got nothing to do with federally-funded employers. The law requires employers of a certain size to offer compliant insurance.
As for expense, it’s more the copay part than the contraception part that raises the beancounters’ eyebrows, but there is a definite cost difference, though whether it’s significant is a matter of opinion. I can’t offer numbers at this point.
The diagnosis is coded differently; if the provisions of prescription drug coverage specify paying differently for different diagnoses, then yes. This will be implemented differently by different plans, so there’s no one answer, but if you want to know whether “they can tell,” the answer is yes.
As an added piece of information, at least one State plan (South Carolina - state and county workers) has been “grandfathered” as far as the new requirements go, and they don’t have to cover contraception until 2014.
Despite that, SC is one of 7 states suing the government over requiring them to cover contraception.