A key goal of President Donald Trump’s health care plan is to make insurance more affordable for many Americans, but coverage gaps remain.
The administration is trying to fix those gaps by requiring employers with 50 or more employees to cover birth control, family planning, mental health, and substance abuse services for workers, and expanding coverage to more people with pre-existing conditions.
But those goals are not enough to overcome the insurance gaps that have prevented millions of Americans from securing coverage.
That’s why a coalition of organizations, faith leaders, and consumer advocates is calling on the Trump administration to expand the federal requirement that coverage must include coverage for contraceptive services.
The mandate was designed to make coverage affordable for millions of women and families.
But many employers aren’t doing enough to provide those benefits, especially for lower-income and uninsured workers, according to a report released by the National Conference of State Legislatures.
And the groups report found that many employers are not offering contraception or family planning to their workers.
The report notes that nearly 1 in 10 employers do not provide contraception coverage for employees, with only 2.8 million employers offering it.
“Many of these employers have a high percentage of female employees, low numbers of female-to-male trans people and a disproportionately large number of African American and Hispanic employees,” the report says.
“The absence of birth control coverage in these settings, combined with a high rate of unintended pregnancies, can have devastating consequences for women and their families.”
The coalition wants the Department of Health and Human Services to provide a broad range of contraceptive services, including birth control pills and the IUD, for free to all employees.
It also wants the government to create a national plan that covers all contraceptive services and includes coverage for the costs of birth-control pills and IUDs.
“If we do not make these critical investments in contraception coverage, millions of uninsured women and couples will remain without access to affordable coverage, even though they need these preventive services,” said Lisa Simeone, senior vice president for health and human services at the NCSL.
“We need to invest in contraception to help prevent pregnancy and improve birth control access to all women, regardless of gender or economic status.”
The groups report, titled “A Path Forward: Ensuring Access to Birth Control Coverage in the Affordable Care Act,” is based on the findings of a survey of 1,000 health care professionals conducted by the American Medical Association and the Institute of Medicine.
The study was conducted from April to September of this year.
The findings suggest that the health care providers who are currently providing the coverage and who may be most at risk are women and African American women.
African Americans have the highest rate of lack of contraceptive coverage in the country, the report found.
“A clear majority of health care workers who responded to the survey were unaware that contraception was covered in the health plan they were working on,” the NCCSL said.
“Of those health care practitioners, almost one-quarter were unaware of the full cost of the coverage for their workers, as well as of the contraceptive coverage requirements in the plan they are working on.”
The NCCL report found the coverage gaps in the individual market vary widely.
In many states, it found that only about half of the plans offered by insurers cover the contraception coverage.
In Massachusetts, for example, only one out of four plans offer the contraceptive benefit.
In California, only about a quarter of plans cover contraception at all.
“Some employers may not offer contraceptive coverage at all, which can cause significant barriers to coverage for some employees,” said Simeones.
“Employers may be unaware of what contraceptive coverage is, how it is required, and which employees are eligible to purchase it.”
In other states, such as Florida and Georgia, about half the plans available to workers do not cover contraception, even if the plans cover other important contraceptive services like abortion and sterilization.
The NCA report also found that women and women of color are disproportionately affected by the lack of coverage.
African American workers are disproportionately more likely than white workers to have a pre-pregnancy test, a preimplantation genetic diagnosis, and other medical conditions that are not covered by most plans.
“While most employers offer health insurance to their employees, they may not have adequate contraceptive coverage for women of all ages and economic backgrounds,” the survey said.
The coalition is calling for a federal mandate for employer-sponsored birth control.
“This mandate will create a path to affordable contraceptive coverage that is available to every woman in America and help address barriers to women’s access to health care,” said Sarah Tummarello, the president of NCA.
“When we put an end to discrimination and inequality, we can ensure that every American has access to access to reproductive health care.”