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HHS Finalizes Accommodations to Federal Contraceptive Coverage Rules

HHS Finalizes Accommodations to Federal Contraceptive Coverage Rules

July 10, 2015 — HHS on Friday released regulations on the federal contraceptive coverage rules to help ensure that women who work for certain companies that object to providing such coverage will be able to access contraception without copayments, The Hill reports (Ferris, The Hill, 7/10).

Background

The contraceptive coverage rules, which are being implemented under the Affordable Care Act (PL 111-148), require most employers to offer contraceptive coverage in their employer-sponsored health plans. Houses of worship are exempt from the requirement, and not-for-profits that hold themselves out as religious and oppose contraception are eligible for an accommodation that ensures they do not have to pay for or directly provide the coverage to their employees (Women's Health Policy Report, 6/30/14).

Specifically, the accommodation for not-for-profits that hold themselves out as religious and oppose contraception allows such organizations to notify their insurers or third-party administrators of their objection so the insurers or third-party administrators can facilitate contraceptive coverage for members of their health plans. To claim the accommodation, the not-for-profits can either complete a form to send to the insurers or third-party administrators or send a letter to HHS stating that they object to offering contraceptive coverage in their health plans (Women's Health Policy Report, 8/22/14).

Final Regulations

Among other rules, the regulations released Friday finalize that not-for-profits that hold themselves out as religious and oppose contraception can seek a religious accommodation by submitting a letter to their insurers or third-party administrators or by notifying HHS of their opposition (CMS fact sheet, 7/10). HHS will then inform the insurers or third-party administrators so that people insured by such employers can receive contraceptive coverage without copays and at no additional cost or involvement by the objecting organization.

In addition, the rules respond to the Supreme Court's ruling in Hobby Lobby (HHS press release, 7/10). In that ruling, the high court held that closely held corporations cannot be required to provide contraceptive coverage to their employees if the corporations' owners have religious objections to contraception (Women's Health Policy Report, 6/30/14).

Specifically, the rules extend to eligible for-profit companies the same accommodation given to not-for-profits that hold themselves out as religious and oppose contraception (HHS press release, 7/10). Companies only are eligible if they are not publicly traded and if at least 50% of the company is owned by no more than five people, with family members counting as one individual (Gerson Uffalussy, Yahoo! Health, 7/10). Further, the company's "highest governing body," such as its board of directors or owners, must adopt a formal statement on how it objects to providing contraceptive coverage because of its religious beliefs (CMS fact sheet, 7/10).

Comments

HHS Secretary Sylvia Mathews Burwell said the finalized regulations "secur[e] women's access to important preventive services at no additional cost under the [ACA], while respecting religious beliefs."

Sen. Patty Murray (D-Wash.) said, "Today's announcement allows a wide range of businesses power over the health care decisions of the women they employ, and shows once again why the Supreme Court's deeply harmful ruling in Burwell v. Hobby Lobby is completely unacceptable" (The Hill, 7/10).

Cecile Richards, president of Planned Parenthood Action Fund, noted, "While we are pleased that the Obama Administration is ensuring that women will get to keep birth control coverage regardless of their employers' personal beliefs, this accommodation shouldn't be necessary in the first place. A private company shouldn't be able to pick and choose what health care services they provide to their employees because they are women, LGBT, or any other class of people." She added, "The Supreme Court was wrong to allow companies to discriminate against their employees this way, and Congress needs to pass legislation to fix it" (Yahoo! Health, 7/10).

Meanwhile, according to National Journal, it "remains to be seen" whether companies that oppose contraception will accept the finalized accommodations. According to the Kaiser Family Foundation, courts currently are weighing more than 40 challenges to the rules, with many plaintiffs contending that the accommodations violate their religious freedom because contraception remains covered (Scott, National Journal, 7/10).