Out-of-pocket spending on most major birth control methods fell sharply in the months after the Affordable Care Act began requiring insurance plans to cover contraception at no cost to women, a new study has found. Spending on the pill, the most popular form of prescription birth control, dropped by about half in the first six months of 2013, compared with the same period in 2012, before the mandate took effect. The study, by health economists from the University of Pennsylvania, analyzed health insurance claims from a large private insurer with business in all 50 states and the District of Columbia. It evaluated the effect of the Affordable Care Act, the biggest piece of social legislation in decades, on women's pocketbooks. It estimated that savings from the pill alone were about $1.4 billion in 2013.
1. Some insurers weren't complying with the mandate. Two recent investigations -- one by the Kaiser Family Foundation and another by the National Women's Law Center -- found that some insurers were skirting the rules and using a loophole to continue charging for contraceptives. The White House took steps in May to close that loophole, and you can read more about that here. 2. Not every single contraceptive gets covered at no cost. Insurance plans are required to cover every type of FDA-approved contraceptive including pills, patches, and implants. But they aren't required to cover every single option in each category. There are dozens of different birth control pills, for example, and an insurance plan could decide to cover one or two of them. Women who still want the other pills would face charges. 3. Some health insurance plans are "grandfathered." Plans that existed prior to Obamacare becoming law back in 2010 are eligible for a "grandfathering" exemption from the birth control mandate, so long as they don't change their benefit package significantly. Insurers generally do like to change benefit packages, though. So over the past five years, the number of grandfathered plans has shrunk, but some of them still exist -- and don't have to provide birth control at no cost.