New York state issued new regulations Saturday that require insurers to provide contraceptives without any cost sharing to patients. The state is preparing to preserve one of the more popular elements of the Affordable Care Act, should the law be repealed.
“An insurer shall cover at least one form of contraception within each of the methods of contraception that the federal Food and Drug Administration has identified for women without annual deductibles or coinsurance, including copayments,” the new regulation reads.
You can read the full regulation here, which will officially take effect in 60 days.
New York’s action shows how states may be able to preserve certain parts of Obamacare even if Republicans’ repeal efforts are successful. There are a few signs of this elsewhere in the country too: Colorado is exploring how to continue running its state marketplace in a post-Obamacare world. Other Democratic governors may look to New York Gov. Andrew Cuomo’s work in this space as an example to follow.
Some parts of the Affordable Care Act are easier to preserve than others. The birth control mandate is low-hanging fruit; all it requires is the state insurance regulators putting out new guidance on what health plans must cover. Other parts of the law, like the tax credits to make health insurance affordable, or Medicaid expansion, are harder because they would require significant state spending.
One last thing I found notable about the New York action: While it does maintain the birth control mandate, it does not preserve the rest of the Affordable Care Act’s preventive health benefits for women. Obamacare requires coverage of about two dozen women-specific preventive health benefits, including breastfeeding supplies (leading to a surprising boom in the breast pump business) and a whole suite of STD tests. These are services that women could lose coverage for in New York, even if the birth control mandate were preserved.
Update: Larry Levitt at the Kaiser Family Foundation emails to point out an important limitation of the New York regulation: it cannot touch self-funded health insurance plans, where employers are responsible for all claims filed by their members (rather than paying an outside health plan a set amount of dollars for premiums). These plans make up a growing part of the market, and point to another difficulty in replacing the health care law at the state level.