State study measures cost of free birth control bill

Massachusetts already requires insurers to cover birth control, but not without co-payments

(AP Photo/Rich Pedroncelli, File)

BOSTON (SHNS) – Legislative leaders looking to fast track a bill that would guarantee women in Massachusetts access to free coverage for birth control received a cost analysis key to moving the measure forward that determined the benefit would add between 7 cents and 20 cents to monthly health insurance premiums.

The review produced by the Center for Health Information and Analysis found that mandating coverage of birth control without co-payments for women in Massachusetts would cost the health care system between $1.9 million and $5.7 million annually over the next five years.

The per month per member increase would amount to an increase of less than one half of 1 percent in total premiums for employers and individuals.

Rep. Aaron Michlewitz and Sen. Jamie Eldridge wrote to CHIA in early October requesting an expedited review of the legislation after President Donald Trump expanded employers’ ability to opt out of the free birth control coverage requirement in the Affordable Care Act on moral grounds.

State law requires a cost analysis of all proposed new insurance benefit mandates before they can be moved out of committee.

“We’re taking a look at. We’re reviewing it. And hopefully we’ll have some news shortly,” Michlewitz told the News Service Wednesday. The CHIA report was filed with the Legislature Tuesday evening, and the North End Democrat said he spent part of the night reviewing its finding.

Michlewitz could not say whether he would push for a vote in the House before the Legislature breaks for the holidays on Nov. 15 until after the New Year.

“We want to make sure that it’s properly constructed, and because there was an agreement between the insurers and the advocacy groups, we’re trying to make sure all those pieces can get done. We would like to do something sooner rather than later, but I don’t want to put a timeline on it because I don’t think that’s fair to the issue,” Michlewitz said.

Massachusetts already requires insurers to cover birth control, but not without co-payments.

The so-called ACCESS bill, filed by Senate Majority Leader Harriette Chandler and Speaker Pro Tempore Patricia Haddad, would guarantee free access to oral contraception for women in Massachusetts, let women pick up a 12-month supply of birth control after their initial prescription, and mandate coverage of emergency contraception at pharmacies without a copayment or a new prescription.

Before a hearing on the legislation last month, Massachusetts health insurers and advocates, including Planned Parenthood, announced that they had agreed to compromise language that would ensure their support for the bill, if added.

The 78-page report, prepared for CHIA by BerryDunn, found that the most costly element to the legislation was the requirement that insurers cover all versions of prescribed, FDA-approved oral contraceptives without cost sharing.

In total, the new coverage mandates would add between 84 cents and $2.40 to the annual premiums for a Massachusetts subscribers, or an increase of 0.042 percent on the high end.

CHIA also noted that at least one study has shown that women receiving birth control pills for 13 cycles at a time were more likely to receive routine and recommended Pap and chlamydia tests and were less likely to have a pregnancy test than women who had to fill their prescriptions more regularly. Women who received a full year’s supply of birth control were also 30 percent less likely to have an unintended pregnancy than women receiving one, three-month supply.

“It’s certainly reasonable for what we’re trying to accomplish here, but I think we need to delve a little more into the numbers and take a closer look at it before we make a full determination from the committee’s standpoint,” Michlewitz said.

He added, “Let’s put it this way. It wouldn’t be the highest per member per month we’ve ever done, but it would certainly not be the lowest.”

Some Catholic organizations oppose the bill, despite the exemption for church or qualified church-controlled organizations who would be allowed to opt out. The protections for free birth control would also not apply to the self-insured market, which accounts for many large employers in Massachusetts.

Catholic Action League Executive Director C.J. Doyle has called the bill a “special interest legislation is intended to maximize contraceptive use.”

Gov. Charlie Baker pledged in March to use state resources to offset federal funding cuts to Planned Parenthood that were being threatened by Republicans in Congress, and said last month after Trump issued new birth control coverage rules that he supports the concepts of the compromise struck in Massachusetts between insurers and advocates.