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Maryland set to expand contraceptive coverage

'Biggest women’s health victory in Maryland for a generation'

Karen Nelson, President and CEO of Planned Parenthood of Maryland sitting next to various types of contraceptives.  (The Daily Record / Maximilian Franz)

Karen Nelson, President and CEO of Planned Parenthood of Maryland sitting next to various types of contraceptives. (The Daily Record / Maximilian Franz)

Maryland is set to increase access to contraceptive care for both women and men, a move supporters say will provide the most comprehensive birth-control coverage in the country.

Insurers will no longer be allowed to charge co-pays for most forms of prescription birth control, will have to provide coverage for over-the-counter contraceptives like the morning-after pill, and generally must provide patients with a six-month supply of their birth-control prescriptions at one time.

Legislation enacting those changes, passed by the General Assembly earlier this year and scheduled to be signed into law by Gov. Larry Hogan Tuesday morning, drew enthusiastic praise from Planned Parenthood, the nonprofit that provides reproductive health care.

“Any time there is an out-of-pocket cost, any time there is a time delay in receiving birth control we know it can be detrimental to women and to public health,” said Karen Nelson, president and CEO of Planned Parenthood of Maryland.

At a time when many states are restricting access to reproductive care, the legislation establishes Maryland as a leader in providing those services, she said.

Under the federal Affordable Care Act, insurers must cover – at no cost to women – at least one product from every one of the 18 categories of birth control approved by the U.S. Food and Drug Administration. Those categories include oral contraceptives, implantable rods and injections.

Now, if a woman and her doctor decide she should switch to a different product within the same category, she can be assured that that one, too, won’t have a copay, said Del. Ariana Kelly, D-Montgomery, the bill’s lead sponsor in the House of Delegates.

The bill, which will take effect Jan. 1, 2018, also does away with requirements that patients get prior authorization from their insurers before they can get intrauterine devices (IUDs) and implantable rods, generally considered the most effective form of birth control because they can last for years.

The legislation should allow women to request and receive those forms of contraception on the same day, rather than making multiple trips to their doctors, Nelson said.

Insurers can still require prior authorization for certain IUDs and implants the FDA says come with serious or life-threatening risks.

While the initial version of the bill called for 13-month supplies of oral contraceptive to be disbursed at one time, the League of Life and Health Insurers of Maryland objected to that provision. At a bill hearing in March, the league argued that since health insurance plans operate on 12-month policy years, in each subsequent year a larger amount of the medication would be covered outside of the plan year.

The bill was amended to reduce the disbursement amount to six months’ worth, or less if that amount extended beyond the current plan year, according to legislative analysts.

There’s a provision for men, too: Insurers that provide hospital, medical and surgical benefits must also cover vasectomies; surgical sterilization for women already is covered under the ACA.

Kelly – with a mild laugh – said it’s only fair: If a couple chooses sterilization, insurance companies shouldn’t influence who undergoes the procedure, she said.

Requiring insurers to cover the morning-after pill at point of sale, similar to flu shots, is another crucial provision. A woman won’t need to worry about paying the out-of-pocket cost for the medication at a time when she knows she needs to take it, Kelly said.

“I think this is the biggest women’s health victory in Maryland for a generation,” she said.