contraceptive-pills-849413__340-300x173-2113624In addition to being one of the wedge issues that paralyzed the state Senate this week, the Comprehensive Contraceptive Coverage Act is also an insurance mandate. And like the dozens of other mandates pending in Albany, it’s being debated without a clear analysis of costs and benefits.

Contrary to what its name suggests, the bill is not about ensuring coverage of birth control pills, IUDs and other contraceptive drugs and devices. That coverage is already mandated, without cost-sharing, by existing laws and regulations at both the federal and state level.

The bill’s practical effects would be incremental, including eliminating cost-sharing for sterilization procedures such as vasectomy and tubal ligation, and allowing patients to receive 12 months’ worth of contraceptives with an initial prescription.

The legislation was originally proposed in January 2017 by then-Attorney General Eric Schneiderman, who resigned last month after several women accused him of assaulting them.

Back then, President Trump was about to take office and congressional Republicans were vowing to repeal the Affordable Care Act (ACA), which included birth control as one of the preventive services that all health plans must cover without cost-sharing (meaning copayments, coinsurance and deductibles). New York law also requires coverage for birth control, but did not prohibit cost-sharing.

Since then, however, the GOP’s attempts to repeal and replace the ACA have repeatedly failed—and its provisions relating to birth control remain in largely in force. The Trump administration broadened exemptions for certain employers with religious or moral objections to contraception, but those are overridden in New York by state law.

Last year, the Cuomo administration issued regulations barring cost-sharing for contraceptives and requiring plans to provide at least a three-month supply on the initial prescription, and a 12-month supply on subsequent refills.

With the original legislation rendered largely redundant, its main function now is as a political symbol—with supporters portraying it as a boost for reproductive rights and women’s rights generally.

This week, Democrats tried to attach the Comprehensive Contraceptive Coverage Act as a hostile amendment to unrelated legislation in the state Senate, as a way of forcing Republicans to cast politically awkward votes. Democrats did the same with the Reproductive Health Act, which would restate and broaden the legalization of abortion in state law.

Lacking votes to block the maneuver, Senate Republicans responded by abruptly adjourning—and the house was unable to pass any bills for the rest of the week.

With respect to the Comprehensive Contraception Coverage Act, the political squabbling has overshadowed substantive flaws—which should concern even those who wholeheartedly support birth control.

Take, for instance, the focus on eliminating cost-sharing. The issue is largely moot for now, since that policy is already established by federal law and state regulation. But even if those laws and regulations went away, it’s not clear that the state should be wiping out cost-sharing for all contraception users at all income levels, including wealthy people who could easily afford a copayment of $30 or $50 a month. One side effect of that unnecessary benefit is marginally higher premiums for everyone, including lower-income insurance customers who don’t need or use contraceptives at all.

Nor is there an obvious reason why contraceptives should be provided a year’s worth at a time, when life-saving medications such as insulin are not. Twelve-month prescriptions would be wasteful if, for example, a patient decides to go off birth control or change contraceptive methods a few weeks later after filling one.

The bill also sets the precedent of prohibiting cost-sharing for sterilization, which is an elective surgical procedure as opposed to a drug or device. Why shouldn’t it get the same treatment as removal of a cancerous tumor or repair of a cleft palate?

How much higher this particular bill would push premiums is unknown. The Legislature never formally analyzes the cost impact of insurance mandates, despite voting 11 years ago to do just that.

But if these provisions become law, other patient and provider groups would undoubtedly seek similar enhanced coverage for drugs, devices and procedures important to them. And New York’s health insurance premiums, already among the highest in the country, would grow costlier still.

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

One of New York’s Biggest Medicaid Contractors Is Quietly Acquiring a Competitor

Author's note: This post has been updated to correct an error in the second paragraph. As state lawmakers debate the future of Medicaid home care, one of the program's bigg Read More

The Union Gave Them the Wrong Data. The Pols Cited It Anyway.

The episode shows the extent to which New York elected officials fail to question the state’s public employee unions—or look at data themselves. Read More

New York’s Home Health Workforce Jumped by 12 Percent in One Year

New York's home health workforce has continued its pattern of extraordinary growth, increasing by 62,000 jobs or 12 percent in a single year, according to newly released data from the U.S. Bureau of Labor Statistics.  Read More

While New York’s Medicaid Budget Soared, Public Health Funding Languished

Four years after a devastating pandemic, the state has made no major investment to repair or improve its public health defenses. While funding for Medicaid over the past four years Read More

Unions are pressing bogus arguments for blowing up NY’s public pension debts

New York's public employee unions are arguing, without evidence, that state lawmakers need to retroactively sweeten the pensions of workers who have been on the job for more than a decade. In fact, state and federal data show why state lawmakers shouldn't. Read More

A Medicaid Grant Recipient Sponsors a Pro-Hochul Publicity Campaign

While much of the health-care industry is attacking Governor Hochul's Medicaid budget, at least one organization is rallying to her side: Somos Community Care, a politically active medical group in the Bronx that recently r Read More

New Jersey’s Pandemic Report Shines Harsh Light on a New York Scandal

A recently published independent review of New Jersey's pandemic response holds lessons for New York on at least two levels. First, it marked the only serious attempt by any state t Read More

Senate, Assembly Budget Plans Include $4B Pension Giveaway

A little-noticed provision in lawmakers’ budget proposals would also be the most costly: their proposal to change state retirement rules would slam New York taxpayers with more than $4 billion in new debt, and immediately drive up pension costs, by retroactively sweetening the pension benefits of public employees. Read More