Physicians suggest the federal government get more involved in accommodating not-for-profits that object to the Affordable Care Act's birth control employer coverage requirement.
In July, the CMS asked the general public for suggestions—much like the U.S. Supreme Court asked for a compromise on the issue—on adhering to the mandate that employers provide coverage for birth control. Some religious not-for-profits object, saying it goes against their religious doctrine.
Employers can apply for exemptions that enlist either third-party administrators or the federal government. But petitioners in several court cases including Zubik v. Burwell, which was returned to the lower court this summer, claim even that accommodation makes them complicit in providing birth control.
In response to the request from the CMS, physicians from the Catholic Medical Association suggested having the government offer a contraceptives-only plan. It would work much like other limited-0scope insurance products such as those that cover pregnancy-related expenses, or cover only a catastrophic medical event. Some limited-scope insurance products cover services not covered by traditional insurance, such as vision, dental or long-term care plans.
Another idea was to allow pharmacies to bill the government for contraceptive prescriptions that are not covered by an insurance policy.
The agency received nearly 55,000 comments by its Sept. 20 deadline. Most came from religious not-for-profits, but many from the medical community expressed concern.
In a joint letter, the American Congress of Obstetricians and Gynecologists, the American Academy of Family Physicians and the American Academy of Pediatrics argued that the CMS doesn't need to offer any other accommodation and criticized some of the ideas presented.
“The alternatives opponents of the accommodation have proposed would remove contraceptive care from a woman's routine health services and require her to use a two-tiered system of access and coverage,” the letter says.
“None of the alternatives proposed most often by opponents of the existing accommodation do what the accommodation does: provide plan beneficiaries with cost-free contraceptives from their pre‐existing health insurance plan.”
Earlier this summer, Supreme Court justices agreed. They asked for a compromise from petitioners, which include Little Sisters of the Poor.
They suggested that the government could require insurance companies contracting with the religious not-for-profits to offer separate plans to the groups' employees that do include contraception coverage.
Those plans could be individual or group and be federally funded. The insurers could contact the groups' employees directly to offer the coverage, keeping the not-for-profits, as organizations, out of it.
The court ultimately decided to punt cases over the issue to lower courts, asking those courts to help reach compromise decisions.