Democrats are pushing to ensure women get free birth control promised by ACA
Sens. Patty Murray (D-Wash.) and Ron Wyden (D-Ore.), who chair the health and finance committees respectively, said they would launch an investigation into health insurer complaints Denying patients’ requests for birth control and forcing them to pay out of pocket.
“We hear from patients being asked to go through ridiculous, crazy, and unnecessary steps to get the birth control that works for them,” Murray said in an interview, emphasizing that access to birth control is a key pillar of reproductive health. “Those who want to take away your abortion rights are not going to stop here… And we must stand up and fight back with everything we have.”
Federal law requires insurers to cover birth control without copayments, a policy the National Women’s Law Center estimated applies to 64 million women as of November 2020, though some religious organizations and other employers have used exemptions to opt out. However, NWLC and other advocates have accused federal and state agencies of not aggressively enforcing the regulations, highlighting examples of insured patients who have been denied coverage. The Biden administration chastised insurers in January after receiving it “Complaints and public reports about possible contraceptive violations.”
The issue has become even more relevant following the release of a leaked draft Supreme Court decision that would overturn the constitutional right to abortion, which has underscored the need for access to birth control to avoid unplanned pregnancies.
“It’s all connected, right? People don’t really live problem lives, and they experience their reproductive health as a life course,” said Raegan McDonald-Mosley, an OB/GYN who leads Power to Decide, an advocacy group focused on preventing unplanned pregnancies. “It’s a continuum, and I think it’s very disturbing … that there have been a few moments where lawmakers have hinted that birth control is next.”
Murray, Wyden and Sens. Robert P. Casey Jr. (D-Pa.) and Maggie Hassan (DN.H.) sent Letters Monday to OptumRx, CVS Caremark and Express Scripts — which together help insurance companies monitor pharmacy benefits for tens of millions of Americans — urging the companies to release information about their birth control insurance policies, what percentage of patient requests have been denied, and so related data within the next two weeks. The letters were shared with the Washington Post.
OptumRx and CVS Caremark spokespeople said they would review the senators’ request.
“UnitedHealth Group is committed to ensuring that the people we serve have timely access to a variety of high-quality, affordable, FDA-approved contraceptives,” said Drew Krejci, a spokesman for Optum. “In accordance with the ACA, OptumRx’s offerings include free options in each contraceptive category, and we will be working directly with Senate offices to address your request.”
Express Scripts spokespeople did not respond to calls and emails requesting comment.
Murray said the investigation, which builds on earlier warnings from lawmakers, is designed to pressure federal officials to step up enforcement.
“We need a really comprehensive guide for insurers from HHS to really make these people understand that they can’t circumvent the law. They have to provide access to birth control,” she said. “Period.”
Advocates cited prevention guidelines from at least a dozen insurers and pharmacy benefit administrators, which they said appeared to flout the law. Power to Decide reviewed 48 rejection letters and conducted a secret phone survey of buyers, finding examples of rejected requests that allegedly ignored doctors’ recommendations, failed to provide adequate information, and otherwise violated standards required by the ACA.
“If you look at these publicly available plan documents, if you look at what’s being sent to consumers in rejection letters, and if you look at these secret buyer calls to customer service hotlines, I think that shows what we’ve all found in our.” Be true to life – it’s very difficult to navigate the health insurance system to the coverage you need,” said Rachel Fey, who helped oversee the Power to Decide report shared with The Post. Officials with the power to rule announced that the group had received funding from drug companies that make contraceptives.
The Democrats’ push to ensure access to free contraception was planned ahead of a Politico report Monday night that the Supreme Court privately voted to overturn Roe v. calfthe nearly 50-year-old court ruling making abortion constitutional protected right, and to uphold Mississippi’s abortion law, which bans abortions after 15 weeks. Chief Justice John G. Roberts Jr. confirmed the authenticity of the draft on Tuesday, while warning that the judges’ positions and the leaked opinion of Judge Samuel A. Alito Jr. were not final. But lawmakers and lawyers drew connections between the fate of roe and a range of reproductive health services, warning of a potential knock-on effect.
“The Republican Party has set the stage for a total erosion of Americans’ constitutional rights,” Wyden said in a statement. “They have made it clear that they will not stop denying a woman the right to make decisions about her own body.”
Some conservatives have argued that the federal government is wrong in telling employers what healthcare they must provide, and have campaigned for years against ACA rules on birth control products. The Susan B. Anthony List, an anti-abortion group, has repeatedly called on Trump administration officials to restrict the law, calling it an “abortion drug mandate.”
Sen. Marsha Blackburn (R-Tenn.) and other Republicans have also criticized a 1965 ruling that upheld the legal right of married couples to birth control. Griswold vs. Connecticut. Alito’s leaked statement also contains arguments that could lead to that decision being ultimately overturned, experts argued.
“roe largely abandoned Griswold vs. Connecticut, which established a right to privacy over the use of contraception by grouping together various provisions and cases that in one form or another protected an area of privacy or liberty,” Boston University law professor Robert Tsai wrote in Politico on Tuesday magazines. “The same allegation Alito is fighting roe can also be done about it Griswold.”
Democrats also predicted the Supreme Court verdict on Mississippi’s abortion law is likely and other challenges to reproductive rights would emerge as a rallying cry ahead of November’s midterm elections, in which the party is expected to lose control of one or both houses of Congress. According to a 2021 PRRI poll, a majority of Americans believe that most employers, with the exception of places of worship, should be required to offer health insurance that covers worker birth control, even if it goes against their religious beliefs.
“I think women’s rights and women’s ability to make their own health care decisions about planning their own families will definitely be up for a vote in November,” Murray said.
The leaked Supreme Court ruling “should shake up voters,” added Debra Curtis, a former Democratic staffer who helped draft ACA legislation and is now a vice president at McDermott+Consulting, a policy consulting firm. “It’s definitely a phone call. If women don’t hear that call, then times have definitely changed.”