Q. Do student health policies have to cover birth control without co-pays?
A. Yes. Policies that began on or after August 1, 2012, are required to provide all FDA-approved contraceptive methods for women, including sterilization, with no cost-sharing. That doesn’t mean that every birth control option for women is provided at no cost. Rather, it means at least one version of every type of contraceptive is covered at no cost to the patient.
Religious employers are exempt from the mandate to cover contraceptives for their employees. But religiously affiliated nonprofit employers such as universities and hospitals were not considered religious employers under the ACA. However, that position was challenged by Hobby Lobby in a highly-publicized case that ended up before the Supreme Court in 2015.
The Court ruled that Hobby Lobby (and other “closely held” corporations with religious objections to some or all contraceptives) did not have to cover certain types of contraceptives under its health insurance plan. HHS quickly issued an accommodation that essentially creates a separate plan under which the women can obtain contraceptives as needed.
But the requirement that health plans fully cover contraceptives may change under the Trump Administration. The mandate itself isn’t part of the ACA. The ACA just requires health plans to cover the ten essential health benefits, one of which is preventive care at no charge to the patient. The task of defining what should be included under the preventive care umbrella was left to HHS, and the agency created guidelines after the ACA had been implemented. So the Trump Administration HHS has the flexibility to change those guidelines, as regulatory changes can be made without the need to pass legislation.
In May 2017, Vox obtained a leaked draft of a new regulation that would allow any employer, school, or insurance plan to opt out of providing contraceptive coverage for any moral or religious reason they choose. Under the terms of the draft regulation, employers — or schools, in the case of student health plans — would not have to go through an official waiver process, but would simply be able to notify plan members that contraceptives would no longer be covered.
The draft regulation was dated May 23. There was some public backlash after it was leaked, and it’s unclear whether the Trump Administration will proceed with that version of the regulation, promulgate something entirely different, or keep the current regulations in place. As of early June, no new regulations had been officially introduced. But it’s worthwhile to be aware that the contraceptive mandate might not remain as comprehensive during the Trump Administration as it was during the Obama Administration.