The Obama administration's controversial preventive-services policy resurfaced Friday when HHS and the Labor and Treasury departments issued an advance notice of proposed rulemaking that includes proposals and seeks comment from all Americans on how to implement a new policy
that President Barack Obama and HHS Kathleen Sebelius announced last month.
In that February proposal, the administration sought to accommodate religious employers that object to providing contraceptive services in health plans by requiring insurance companies, not the employers, to offer those services directly to women at no charge.
The guidance issued Friday suggests ways to incorporate this proposal in self-insured group plans. One idea is for a third-party administrator to use sources of revenue that are not obligated to plan sponsors, such as drug rebates or disease-management program fees, to pay for the services. “Additionally, nothing precludes a third-party administrator from receiving funds from a private, non-profit organization to pay for contraceptive services for the participants and beneficiaries covered under the plan of a religious organization,” the guidance noted.
Another recommendation suggests that an additional entity other than a third-party administrator arrange for contraceptive coverage. For this, the three departments are considering that the Office of Personnel Management identify a private insurer to offer coverage. The Affordable Care Act requires that the Office of Personnel Management contract with at least two insurers to offer multi-state plans in the exchanges “Accordingly, OPM could incentivize or require one or more of the insurers offering a multi-state plan also to provide, at no additional charge, contraceptive coverage to participants and beneficiaries covered under religious organizations’ self-insured plans,” the advance notice said.
There is a 90-day comment period for this advance notice of proposed rulemaking, and the departments plan to host listening sessions. An administration official on Friday said that contraceptive coverage can accrue savings, and that the departments are seeking input not only on the outlined proposals, but also on information related to costs.
Also Friday, the administration issued a final regulation (PDF)
on student health plans. Students will have the same consumer protections as those in an individual insurance market, such as prohibition on lifetime limits and coverage of preventive services without cost-sharing. “In the same way that religious colleges and universities will not have to pay, arrange or refer for contraceptive coverage for their employees,” HHS noted in a news release
, “they will not have to do so for their students who will get such coverage directly and separately from their insurer.”