NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A8135B REVISED 1/20/16
SPONSOR: Cahill (MS) TITLE OF BILL: An act to amend the insurance law, the social services
law, the education law and the public health law, in relation to requir-
ing health insurance policies to include coverage of all FDA-approved
contraceptive drugs, devices, and products, as well as voluntary steri-
lization procedures, contraceptive education and counseling, and related
follow up services and prohibiting a health insurance policy from impos-
ing any cost-sharing requirements or other restrictions or delays with
respect to this coverage
PURPOSE: This legislation will help to reduce the number of unin-
tended pregnancies, improve birth outcomes and improve the health and
welfare of New Yorkers by ensuring that individuals have timely access
to contraception and the information they need in order to plan their
families and their future.
SUMMARY OF SPECIFIC PROVISIONS:
Section 1. Provides that the act shall be known and may be cited as the
Comprehensive Contraception Coverage Act.
Section 2. Amends paragraph 16 of subsection (1) of section 3221 of the
insurance law to require commercial group health insurance policies to
cover all FDA-approved contraceptive drugs, devices and products when
prescribed by a health care provider.
When the FDA has approved one or more therapeutic and pharmaceutical
equivalent versions of a contraceptive drug, device or product, coverage
is not required for equivalent versions of the contraceptive drug unless
the equivalent is not available or is medically inadvisable. Coverage
shall: (i) include emergency contraception when prescribed through a
prescription or a non-patient specific order; (ii) allow for dispensing
of up to twelve months of contraception; (iii) include voluntary steri-
lization procedures for women and men; (iv) include patient education
and counseling about contraception; and (v) include any follow-up care
related to the covered contraceptives including management of side-ef-
fects, counseling and device insertion and removal.
An insurer may not apply co-pays or deductibles when coverage for a
contraceptive method is required. In addition, no restrictions, or
delays in coverage can be applied when coverage for a contraceptive
method is required. Coverage for an enrollee's covered spouse, domestic
partner and covered dependents shall be the same as for the enrollee.
"Conscience protections" in existing law remain untouched. Specif-
ically, the bill does not amend existing law which allows a religious
employer to request an insurance policy without coverage for FDA-ap-
proved contraceptive methods that are contrary to the religious employ-
er's religious tenets.
Sections 3 and 4. Makes similar changes outlined in Section 2 to
subsection (cc) of Section 4303 of the insurance law relating to nonpro-
fit medical indemnity, or health and hospital service corporations and
subparagraph (E) of paragraph 17 of subsection (i) of section 3216 of
the insurance law relating to individual health insurance policies.
Section 5. Amends paragraph (d) of subdivision 3 of section 365-a of the
social services law to expand the definition of "medical services" to
include 12 months of contraceptive supplies for eligible persons.
Section 6. Amends subdivision six of section 6527 of the education law
to authorize a registered professional nurse to administer or dispense
emergency contraception to a patient and authorizes a pharmacist to
dispense emergency contraception to be self-administered by the patient.
Section 7. Amends subdivision 3 of section 6807 of the education law to
add a licensed midwife to the list of practitioners who may prescribe or
order a non-patient specific regimen. Also, adds a new subdivision to
the education law providing that a licensed pharmacist may dispense a
non-patient specific regimen of emergency contraception, to be self-ad-
ministered by the patient, which was prescribed or ordered by a licensed
physician, certified nurse practitioner, or licensed midwife.
Section 8. Adds a new section 6832 to the education law to: (i) define
the terms "emergency contraception" and "prescriber"; (ii) provide that
this section does not apply to administering or dispensing emergency
contraception when lawfully done without a prescription or non-patient
specific regimen; (iii) require that the administering or dispensing of
emergency contraception by a registered professional nurse or licensed
pharmacist be done in accordance with professional standards of practice
and in accordance with written procedures and protocols; and (iv)
outline the contents of written material that must be provided to the
patient when emergency contraception is administered or dispensed. Such
written material shall be developed or approved by the commissioner in
consultation with the Department of Health (DOH) and the American
College of Obstetricians and Gynecologists (AGOG).
Section 9. Amends subdivision 4 of Section 6909 of the education law to
authorize a registered professional nurse to administer or dispense
emergency contraception to a patient and a pharmacist to dispense emer-
gency contraception to be self-administered by the patient.
Section 10. Amends subdivision five of section 6909 of the education law
by adding a licensed midwife to those practitioners who may prescribe
and order a non-patient specific regimen of emergency contraception.
Section 11. Adds a new subdivision 4 to section 6951 of the education
law to authorize a licensed midwife to prescribe and order a non-patient
specific regimen of emergency contraception to be administered or
dispensed by a registered professional nurse or dispensed by a licensed
pharmacist.
Sections 10, 11, and 12. Amends three sections of the insurance law to
mandate that under these sections any insurance policy that covers emer-
gency contraception shall also cover emergency contraception when
provided by a non-patient-specific prescription.
Section 12. Adds a new paragraph (1) to subdivision one of section 207
of the public health law to broaden the NYS Department of Health's
education and outreach program to include information on emergency
contraception and its safety, efficacy, appropriate use and availabili-
ty.
Section 13. Provides that this act shall take effect on January 1, 2017,
provided however that section six shall take effect on January 1, 2018.
JUSTIFICATION: Access to contraceptive services is essential to
women's health and equality. New York has long recognized the central
role that contraception plays in women's health and lives and has led
efforts to expand access to contraception. All New Yorkers, regardless
of economic status, should have timely access to contraception and the
information they need in order to protect their health, plan their fami-
lies and their future. Time and time again, studies show that contracep-
tive access reduces rates of unintended pregnancy, plays a crucial role
in improving public health outcomes, as well as improving the economic
well-being of women and their families.* However, despite legal reform
on the State and Federal level, lack of contraceptive insurance coverage
and high co-payments remain significant barriers to contraceptive
access.
The Contraceptive Equity Act would amend state insurance and social
service laws to require health insurance policies to include coverage of
all Food and Drug Administration (FDA)-approved contraceptive drugs,
devices, and products, as well as voluntary sterilization procedures,
contraceptive education and counseling, and related follow up servic-
es.**It would also prohibit a health insurance policy from imposing any
cost-sharing requirements or other restriction or delays with respect to
this coverage.
In 2002, the New York State Legislature passed the Women's Health and
Wellness Act, an important first step toward contraceptive equity that
required insurance plans that cover prescriptions to include contracep-
tion. Eight years later, the U.S. Congress passed the Affordable Care
Act (ACA), which includes a contraceptive coverage guarantee as part of
a broader requirement for health insurance plans to cover contraceptive
services without cost-sharing for all women in the Health Insurance
Marketplace.
The contraceptive equity policy is one of the landmark achievements of
the ACA, but a lack of clarity in the federal law has led to inconsist-
ent implementation and enforcement. Insurers can take advantage of this
confusion to limit coverage for the diverse array of contraceptive meth-
ods available and, in some cases, can prevent individuals from accessing
the method deemed most effective by their medical provider. Addi-
tionally, many insurance companies do not typically cover male methods
of contraception or require high cost-sharing despite the critical role
men play in the prevention of unintended pregnancy.
Building on existing state and federal law to promote gender equity and
women's health, this Act would ensure broad contraceptive coverage and
timely access to all federal FDA-approved methods of contraception for
individuals covered under health insurance plans in New York.
PRIOR LEGISLATIVE HISTORY: 2015: A.8135 Referred to Ways & Means
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None.
EFFECTIVE DATE: This act shall take effect on January 1, 2017. Howev-
er, section five shall take effect on January 1, 2018.
*Sonfield, Adam. "What Women Already Know: Documenting the Social and
Economic Benefits of Family Planning." Guttmacher Institute. Winter
2013. http://www.guttmacher.org/pubs/gpr/16/1/gpr160108.html
**For a full list of these devices, see the FDA Office of Women's
Health's Birth Control Guide
http://wwm.fda.gov/downloads/ForConsumers/ByAudience/
ForWomen/FreePublications/UCM356451.pdf
