Maryland Governor Larry Hogan has signed into law the Contraceptive Equity Act, which puts the state at the forefront of efforts to reduce insurance-plan barriers to accessing multiple forms of contraception. When the law takes effect in 2018, insurance plans regulated by Maryland that provide contraceptive coverage will no longer be allowed to charge co-payments for FDA-approved contraceptive drugs, procedures, and devices. This list include vasectomies and emergency-contraceptive pills.
The law will also allow women to receive six months of oral contraceptives at a time, and will prohibit insurers from requiring prior authorization for IUDs and contraceptive implants. The provisions apply to Medicaid plans as well as private insurers.
While the Affordable Care Act took an important step forward by requiring insurers to have at least one form of contraception in each of the FDA’s prescription categories available to women without cost-sharing. However, this could mean that an insurer allows women to get only one kind of combined oral contraceptive pill without paying a co-payment, so many women might find that using the pill that works best for them still requires a monthly fee. It also means that emergency contraceptive pills obtained over the counter, rather than through a provider’s prescription, can still cost women $60. Under Maryland’s law, over-the-counter emergency contraception will now be free to the insured woman purchasing it, and insurers can only require co-payments for forms of contraception that are therapeutically equivalent to others available without cost-sharing (e.g., an insurer can require copayments for branded pills when their generic versions are available without copayments).
Including a popular form of male contraception, vasectomies, on the list of cost-sharing-free contraceptive methods assures that men as well as women will face fewer barriers to deciding if and when to procreate.
Being able to control whether and when to give birth is good for women’s health as well as children’s. Cost and logistics can interfere with contraceptive preferences, which is why laws like Maryland’s are important.