Impact of Mo. Refusal Law Unknown in Face of Legal Challenge

September 19, 2012 — It is unclear how women in Missouri will be affected by a new law (SB 749) allowing employers and health plans to refuse to provide insurance coverage for contraception, abortion or sterilization for religious or moral reasons, the Springfield News-Leader reports.

Legal disputes and federal regulations likely will influence how the law is implemented, according to the News-Leader. A suit challenging the measure argues that it limits women's access to health care and conflicts with civil rights laws and the Affordable Care Act (PL 111-148). Supporters of the law have lauded it as a rebuke to federal rules being implemented under the ACA that require health plans to cover contraception.

To casual observers, the changes to existing law under the new Missouri measure might not be readily apparent, according to Elizabeth Nash of the Guttmacher Institute (Nelson, Springfield News-Leader, 9/18).

The measure revises a 2001 state law that requires health insurance policies that include pharmaceutical benefits to cover birth control prescriptions at the same copayment or deductible levels as other medications. The 2001 law allows health plans to offer policies without the coverage to employers or individuals who oppose contraception, and it ensures that employees can purchase a plan that includes the coverage if their employer does not offer it.

The 2001 law states that insurers "may" offer individuals and employers policies without contraceptive coverage if they request it, while the new law says insurers "shall" provide plans without the coverage. The new law also establishes grounds for the state attorney general and others to file lawsuits claiming religious infringement if entities are required to cover birth control (Women's Health Policy Report, 9/13).