“Contraceptive Equity” is a policy framework under which contraceptive care is easily accessible and covered at no cost in all health programs. Contraceptive Equity acknowledges the critical role that family planning plays in improving health outcomes and economic security for people of reproductive age and their families. Further, Contraceptive Equity addresses the historically inadequate coverage of comprehensive birth control services. This week, the National Health Law Program (NHeLP) published the user-friendly Contraceptive Equity in Action: A Toolkit for State Implementation to serve as a legal and policy resource for states with or considering Contraceptive Equity laws.
While many states have Contraceptive “Parity” laws (requiring coverage of contraceptives in the same manner as other prescription drugs), and the Affordable Care Act (ACA) creates federal requirements for contraceptive coverage, Contraceptive Equity remains elusive. NHeLP’s Model Contraceptive Equity Act (Model Act), which we created after sponsoring Contraceptive Equity legislation in California in 2014, seeks to fill the gaps between parity and equity. The Model Act prevents insurers from erecting service barriers via medical management techniques, like cost-sharing, prior authorization, prescription requirements, gender restrictions, or quantity limitations. Contraceptive Equity laws have been enacted in California, Connecticut, Delaware, Washington, D.C., Illinois, Maine, Maryland, Massachusetts, Nevada, New Hampshire, New York, Oregon, Vermont, and Washington. These laws are crucial to maintaining and expanding access to reproductive and sexual health care moving forward.
Despite the existence of state Contraceptive Equity laws, many of which are already in effect, public education and proper implementation take time and effort. This is where the Toolkit comes in. As NHeLP’s follow-up to the Model Act, it explains how Contraceptive Equity laws fit within the broader federal and state health insurance landscape, and serves as a resource for advocates, media and communications strategists, providers, health insurers, and insurance regulators to understand their state’s Contraceptive Equity laws.
The Toolkit provides a litany of tools, such as a model formulary, sample op-eds, and template language for submitting adverse benefit determination appeals and state agency complaints. Additionally, the Toolkit includes a 50-state survey detailing which states have mandated contraceptive coverage. Finally, it offers best practices tailored to a wide range of stakeholders, from health insurers and regulators responsible for ensuring ensure smooth implementation to providers seeking timely reimbursement for comprehensive services.
As states undertake meaningful strides toward achieving Contraceptive Equity during a time when reproductive and sexual health care is highly vulnerable, it is more important than ever that stakeholders understand and enforce their state’s Contraceptive Equity laws. We hope that this Toolkit will prove a useful resource for doing so.