Study: NJ contraceptive coverage doesn’t meet ACA standards

Two recent studies show some insurers are not following the Affordable Care Act provision that requires all contraception be covered free of cost.

New Jersey was one of five states included in a Kaiser Family Foundation report this month of 20 insurance carriers. It showed some plans charged co-pays or didn’t cover specific types of birth control, including the NuvaRing, birth control patch, and implantable intrauterine device, or IUD.

A second study by the National Women’s Law Center released Wednesday reported similar findings in plans in 15 different states. New Jersey was not among those studied.

Alina Salganicoff, director of women’s health policy at the Kaiser Family Foundation, said the 2010 health law requires all FDA-approved contraceptive methods be covered without cost-sharing, but also allows for “reasonable medical management.”

“There are very appropriate uses for medical management,” Salganicoff said, including requiring patients to try generics first or get prior authorization for some drugs to control costs.

“The question is, when you say that you’re using medical management when you are not offering a particular method of contraception, and using that as a rationale,” is that appropriate, Salganicoff asked.

Advocates are pushing the federal government for clarification.

The report did not name insurance companies or detail which carriers covered which birth control methods, but Salganicoff said the insurance companies surveyed included large national firms, and plans in New Jersey had similar contraceptive coverage policies as plans in the other four states.

The New Jersey insurance department said it investigates all complaints against health insurers and has the authority to impose fines if state or federal law is being violated, but did not respond to a request for comment on the Kaiser report.