Proposed regulations aim to expand contraceptive access and eliminate moral exemption for coverage mandate

Proposed regulations aim to expand contraceptive access and eliminate moral exemption for coverage mandate

The Internal Revenue Service, Department of Labor, and U.S. Health and Human Services Department have issued proposed regulations that would provide an additional method for individuals to obtain no-cost contraceptive services if their health plan or insurer does not provide such services due to a religious exemption. Under final regulations issued in 2018, qualifying religious employers and other entities with sincerely held religious beliefs or moral convictions are exempt from the Affordable Care Act’s contraceptive coverage mandate, which generally requires coverage of contraceptive services without cost-sharing. Exempt entities may voluntarily engage in an accommodation process that allows plan participants to receive contraceptive services directly from a TPA or insurer without the employer’s involvement. In an FAQ issued in 2021, the agencies announced they were considering changes to the 2018 regulations “in light of recent litigation”. Here are highlights of the proposal: 

  • Individual Contraceptive Arrangement: Leaving in place the existing religious exemptions and accommodations, the agencies have proposed to add a new “individual contraceptive arrangement” through which individuals enrolled in plans or coverage sponsored or arranged by entities with religious objections could access no-cost contraceptive services without the involvement of their employer, group health plan, plan sponsor, or insurer. A provider or facility that furnishes contraceptive services in accordance with the individual contraceptive arrangement would be reimbursed through an arrangement with an Exchange insurer, which would request an Exchange user fee adjustment to cover the costs. 
  • Moral Exemption Rescinded: The proposed regulations would revoke the 2018 regulations’ moral exemption and accommodation. The agencies explain that “there have not been a large number of entities that have expressed a desire for an exemption based on a non-religious moral objection” and that there is no legal obligation (including under the Religious Freedom Restoration Act) to provide such an exemption. 

Source: Thomson Reuters 

Proposed regulations aim to expand contraceptive access and eliminate moral exemption for coverage mandate

White House signals COVID-19 public health emergency and national emergency end soon

The Biden Administration announced on Jan. 30 its intent to end the public health emergency and national emergency on May 11, 2023. Former President Donald Trump issued the emergency declaration in March 2020 in response to the nation’s COVID-19 crisis. President Joe Biden extended the emergency again on Feb. 18, 2022. 

The House of Representatives proposed ending the emergency immediately rather than wait until May 11. The administration responded saying that an abrupt end to the emergency declarations would create chaos within the nation’s health care system. 

The 60 days after the end of the national emergency will be significant as benefit related changes will take affect July 10, 2023. For plan sponsors, many benefit-related deadlines were extended as part of the national emergency, such as COBRA election and payment periods. With deadlines extensions ending, plan sponsors should work with COBRA and other third party-administrators in preparation for the rule changes affecting: 

  • election periods for COBRA continuation coverage 
  • COBRA premium payments 
  • HIPPA special enrollments 
  • claims, adverse decision appeals and external reviews