Contraceptive Coverage

States can require private health insurers to provide contraceptive coverage on the same basis as other prescription drugs.¹ Contraceptives can be expensive, and without insurance coverage, many women are forced to either forgo using contraceptives completely or to use less effective methods.

Impact of the Affordable Care Act

All new health plans are required to cover certain preventive services--like cancer screenings and immunizations--for free. In 2011, the list of required preventive services will be updated to ensure that services women in particular need are included, and it is not clear yet whether contraceptive coverage will be required (without copayments) at that point.
Beginning in 2014, new health plans sold to individuals and small businesses will be required to cover a package of "essential health benefits." The law lists ten broad categories of services that will be among the essential benefits--including prescription drugs, preventive services, and wellness care--but the package will be further defined in the coming year by the Secretary of Health and Human Services. It is not yet clear whether all forms of FDA-approved prescription drugs and devices will be a required benefit.

Does the state require private insurers that cover prescription drugs to cover all forms of Food and Drug Administration (FDA)-approved prescription contraceptive drugs and devices? Has the state enacted a religious refusal clause to limit access to contraception?

States receive a "meets policy" if they require private insurance companies that cover prescription drugs to also cover all FDA-approved forms of contraception and have not enacted a refusal clause. States receive a "limited policy" if they require private insurance companies that cover prescription drugs to also cover all FDA-approved forms of contraception but have also enacted a narrow refusal clause. States receive a "weak policy" if they require only certain types of insurers to cover contraception as they do other prescription drugs, or require all or some insurers to offer contraceptive coverage as a benefit in employer-sponsored insurance plans, but have not required that it be a mandated benefit in all of these insurance plans, and/or have enacted a broad refusal clause. States receive a "no policy" if they do not require any coverage of contraceptives.

The way in which this indicator is evaluated has changed from the 2007 Report Card and therefore there is no comparison to 2007. In an effort to more fairly assess the scope of state contraceptive coverage mandates, the categories were expanded to reflect the effect of religious refusal clauses on access to contraceptives.

State	Strength of Policy	Change from 2007
Alabama	No Policy	N/A
Alaska	No Policy	N/A
Arizona	Limited Policy	N/A
Arkansas	Limited Policy	N/A
California	Limited Policy	N/A
Colorado ²	Meets Policy	N/A
Connecticut	Weak Policy	N/A
Delaware	Weak Policy	N/A
District of Columbia	No Policy	N/A
Florida	No Policy	N/A
Georgia	Meets Policy	N/A
Hawaii	Limited Policy	N/A
Idaho	Weak Policy	N/A
Illinois	Meets Policy	N/A
Indiana	No Policy	N/A
Iowa	Meets Policy	N/A
Kansas	No Policy	N/A
Kentucky	Weak Policy	N/A
Louisiana	No Policy	N/A
Maine	Weak Policy	N/A
Maryland	Weak Policy	N/A
Massachusetts	Weak Policy	N/A
Michigan	No Policy	N/A
Minnesota	Weak Policy	N/A
Mississippi	No Policy	N/A
Missouri	Weak Policy	N/A
Montana	No Policy	N/A
Nebraska	No Policy	N/A
Nevada	Weak Policy	N/A
New Hampshire	Meets Policy	N/A
New Jersey	Weak Policy	N/A
New Mexico	Weak Policy	N/A
New York	Limited Policy	N/A
North Carolina	Limited Policy	N/A
North Dakota	Weak Policy	N/A
Ohio	Weak Policy	N/A
Oklahoma	Weak Policy	N/A
Oregon	Limited Policy	N/A
Pennsylvania	No Policy	N/A
Rhode Island	Weak Policy	N/A
South Carolina	No Policy	N/A
South Dakota	No Policy	N/A
Tennessee	No Policy	N/A
Texas	Weak Policy	N/A
Utah	No Policy	N/A
Vermont	Meets Policy	N/A
Virginia	Weak Policy	N/A
Washington	Meets Policy	N/A
West Virginia	Weak Policy	N/A
Wisconsin	Meets Policy	N/A
Wyoming	Weak Policy	N/A

Policy Indicator Counts

Meets Policy:

8

Limited Policy:

7

Weak Policy:

20

No/Harmful Policy:

16

Better:

0

Same:

0

Worse:

0

Data Source: National Women's Law Center, "Contraceptive Equity Laws in Your State: Know Your Rights- Use Your Rights, A Consumer Guide," 2010, available at http://www.nwlc.org/resource/contraceptive-equity-laws-your-state-know-y..., accessed December 5, 2010.

Footnotes

¹ In 1998, Congress passed legislation that requires contraceptive coverage for federal employees who are insured through the Federal Employees Health Benefits Plan (FEHBP). Such a policy has been shown to be cost-effective – for every dollar of public sector investments in contraceptive services, three dollars are saved in Medicaid costs for pregnancy-related health care and medical care for newborns. The Guttmacher Institute, “The Cost of Contraceptive Insurance Coverage,” March 2003, available at http://www.guttmacher.org/pubs/tgr/06/1/gr060112.html, accessed September 1, 2010.

²Colorado requires individual and group health plans to provide coverage for contraception in the same manner as any other sickness, injury, disease, or condition. This requirement takes effect January 1, 2011.