# Tell me like I'm four about government mandated contraception coverage on insurance **URL:** \ **Category:** In My Humble Opinion\ **Created:** [March 3, 2012, 1:13am UTC](https://boards.straightdope.com/t/tell-me-like-im-four-about-government-mandated-contraception-coverage-on-insurance/614607 "2012-03-03T01:13:02Z")\ **Posts on this page:** 3\ **Page:** 1
**Author:** ![Sampiro](https://avatars.discourse-cdn.com/v4/letter/s/2acd7d/32.png) [@Sampiro](https://boards.straightdope.com/u/Sampiro)\ **Post date:** [March 3, 2012, 1:13am UTC](https://boards.straightdope.com/t/tell-me-like-im-four-about-government-mandated-contraception-coverage-on-insurance/614607/1 "2012-03-03T01:13:02Z")
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.) ---
**Author:** ![Nametag](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nametag/32/406_2.png) [@Nametag](https://boards.straightdope.com/u/Nametag)\ **Post date:** [March 4, 2012, 8:01pm UTC](https://boards.straightdope.com/t/tell-me-like-im-four-about-government-mandated-contraception-coverage-on-insurance/614607/2 "2012-03-04T20:01:34Z")
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: > [@](#): > > For purposes of this subsection, a ‘‘religious employer’’ is an organization that meets all of the following criteria: > (1) The inculcation of religious values is the purpose of the organization. > (2) The organization primarily employs persons who share the religious tenets of the organization. > (3) The organization serves primarily persons who share the religious tenets of the organization. > (4) The organization is a nonprofit organization as described in section 6033(a)(1) and section 6033(a)(3)(A)(i) or (iii) of the Internal Revenue Code of 1986, as amended. 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: > [@](#): > > § 147.100 Basis and scope. > > Part 147 of this subchapter implements the requirements of the Patient Protection and Affordable Care Act that apply to group health plans and health insurance issuers in the Group and Individual markets. 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. [45 CFR 147](http://ecfr.gpoaccess.gov/cgi/t/text/text-idx?c=ecfr&tpl=/ecfrbrowse/Title45/45cfr147_main_02.tpl) [The Federal Register](http://www.hrsa.gov/womensguidelines) ---
**Author:** ![Lasciel](https://avatars.discourse-cdn.com/v4/letter/l/e79b87/32.png) [@Lasciel](https://boards.straightdope.com/u/Lasciel)\ **Post date:** [March 4, 2012, 8:26pm UTC](https://boards.straightdope.com/t/tell-me-like-im-four-about-government-mandated-contraception-coverage-on-insurance/614607/3 "2012-03-04T20:26:55Z")
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. Goddamnthem.