Mandates all health insurance contracts from January 1, 2026, to cover FDA-approved contraceptives, sterilization, contraception counseling, follow-up services, and a twelve-month supply for Medicaid recipients.
Impact
The enactment of H6047 is expected to significantly amend state health insurance laws by requiring insurers to cover a range of contraceptive methods devoid of any out-of-pocket costs for the policyholders. This includes removing deductibles, coinsurance, or copayments associated with these services. Moreover, if alternative therapeutic equivalents of prescribed contraceptives are unavailable or medically inadvisable, insurance policies must accommodate the necessary coverage without additional costs to the patients. Consequently, this could lead to improved healthcare outcomes by allowing easier access to contraceptives and related health services.
Summary
House Bill H6047 mandates that all health insurance contracts effective on or after January 1, 2026, must provide comprehensive coverage for all FDA-approved contraceptive drugs and devices, as well as voluntary sterilization procedures. This legislation ensures that policies will cover not only the contraceptives but also clinical services related to their use, which include consultations, examinations, device insertions, and follow-up services. By eliminating cost-sharing for these services, the bill aims to enhance access to reproductive healthcare and support women’s health decisions.
Contention
Despite the bill’s alignment with enhancing reproductive health services, it may face challenges from religious employers and organizations that opt-out of covering contraceptive methods on grounds of moral or religious beliefs. The bill contains provisions allowing such refusals, provided the employers inform prospective enrollees about the specific services they will not cover. This aspect could lead to debates concerning the balance between individual rights to reproductive healthcare and religious freedoms, which may become a point of contention during the discussion and implementation phases of the legislation.
Requires every individual or group health insurance contract effective on or after January 1, 2025, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
Requires every individual or group health insurance contract effective on or after January 1, 2025, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
Requires that any insurance contract issued, amended or renewed on or after January 1, 2025, that provides hospital, medical or surgical coverage shall provide coverage for medically necessary treatment of mental health or substance use disorders.
Adds a new section which sets forth conditions for pharmacists to prescribe tobacco cessation/drug therapies, programs approved by the state board of pharmacy. The cessation therapies would be covered by all health insurance carriers on or after 1/1/25.
Adds a new section which sets forth conditions for pharmacists to prescribe tobacco cessation/drug therapies, programs approved by the state board of pharmacy. The cessation therapies would be covered by all health insurance carriers on or after 1/1/25.
Prohibits insurance companies from paying a rate that is less than the approved Medicaid rate set by the executive office of health and human services.
Requires every individual or group health insurance contract effective on or after January 1, 2025, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
Requires every individual or group health insurance contract effective on or after January 1, 2025, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.
Requires every individual or group health insurance contract effective on or after January 1, 2026, to provide coverage to the insured and the insured's spouse and dependents for all FDA-approved contraceptive drugs, devices and other products.