Sanders demands probe into birth control insurance coverage
Senator Bernie Sanders has urged the Government Accountability Office to look into the oversight of the Affordable Care Act’s requirement for free contraceptive coverage across all 50 states. Despite being federal law for over a decade, many health plans still charge for contraception which should be provided at no cost. Sanders highlighted the persistent lack of enforcement and accountability, pointing to a Vermont investigation that found significant unlawfully charged fees by insurance companies. This call for investigation stresses the importance of following and enforcing the law to ensure patient access without financial barriers.
Sen. Bernie Sanders (I-VT) has called for a government investigation into why some health insurance plans are charging women for contraception that is supposed to be free under federal law.
In all 50 states, the Affordable Care Act guarantees coverage of women’s preventive services, including all Food and Drug Administration-approved birth control methods.
In a letter sent to the Government Accountability Office, Sanders asked to investigate how states and federal entities, like the departments of Health and Human Services, Labor, and Treasury, oversee compliance with the ACA mandate for free contraceptive coverage in health plans.
“The ACA has been federal law for 14 years and we continue to see plans deny coverage and ignore the federal mandate,” Sanders wrote. “It is completely unacceptable that plans consistently defy mandated coverage and that there is little enforcement or accountability.”
He pointed to a recent investigation by the Vermont Department of Financial Regulation, which found that three health insurers (Blue Cross Blue Shield Vermont, MVP Health Care, and Cigna Healthcare) failed to provide free contraceptive services, resulting in $1.5 million in charges to consumers from 2017 to 2021.
“While this important legislation prohibited cost-sharing, co-payments, and deductibles for contraception, the law can only help patients if it is both followed and enforced,” Sanders wrote. “This is critical given the evidence that any cost-sharing can be a barrier to patient access.”
In addition, Sanders cited an October 2022 investigation by the House Oversight and Accountability Committee, which revealed that insurers across the country are not following ACA requirements for contraceptive coverage.
The committee’s report showed that many health plans exclude or charge for at least 34 contraceptive products, and most insurers deny over 40% of exception requests for contraceptives, with one company denying more than 80% annually.
Under the ACA, private health plans are required to cover a variety of recommended preventive services without imposing any cost-sharing on patients. (See the complete list here.) This requirement applies to all private plans, including fully insured and self-insured plans in individual, small group, and large group markets.
The only exception to this mandate applies to plans that maintain “grandfathered” status, which includes individual health insurance policies purchased on or before March 23, 2010. These plans may lose their status if they implement significant changes that decrease benefits or raise costs for consumers.
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In January, the Biden administration issued an executive order expanding access to contraception and family planning services.
Access to contraception has become a political issue, with Democrats emphasizing birth control in their election-year focus on reproductive rights.
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