Worried that the Affordable Care Act's coverage mandates will disappear when Republicans make good on their promise to repeal the law, a number of states are finding ways to continue to offer access to free contraception.
Four states—California, Maryland, Vermont and Illinois—have had laws on the books since 2014 that are similar to or that even go beyond the ACA’s contraceptive coverage mandates, according to an article from Reuters. Now, Democratic legislators in New York, Minnesota, Colorado and Massachusetts are looking to enact their own rules before an ACA repeal occurs.
"I think it is even more important now," Colorado state Rep. Susan Lontine, who co-sponsored a contraception coverage bill last year, told the publication. "We don't know what will happen on the federal level."
New York’s proposed law, for instance, would allow women to fill multiple months of a birth-control prescription at a time, ban private payers from using “medical management” reviews to limit or delay contraception coverage and provide coverage for vasectomies with no copay, according to the article. A 2015 report from the Kaiser Family Foundation noted that contraceptive coverage varies between plans, and that some payers place limits on certain types of contraception and coverage for sterilization procedures also differs.
Research has found that the ACA’s coverage mandate has lowered costs and removed barriers to contraception for women, particularly for more expensive long-term contraceptives like intrauterine devices. Increased use of these effective measures diminished the risk of unintended pregnancy and additional unplanned care costs. Estimates also suggest the law's provisions saved women as much as $1.3 billion in birth-control pill costs.
Meanwhile, President Barack Obama's administration has decided not to make any changes to the ACA's contraceptive coverage mandates, which had been challenged in court on religious grounds. In a frequently asked questions document about implementation of that part of the law, three government agencies say they could find “no feasible approach” to resolve the concerns of religious groups while also continuing to ensure that women "receive full and equal health coverage, including contraceptive coverage."
The decision essentially leaves the question up to President-elect Donald Trump's administration, according to the National Law Journal, which adds that a number of organizations have already expressed concerns that Trump and a Republican-controlled Congress could roll back certain reproductive rights.