Raskin presses insurers, PBMs on free contraception protection

The highest Democrat on the Home Oversight and Accountability Committee desires to understand how the nation’s prime Health insurers and pharmacy profit managers plan to make IT simpler for folks to entry contraception at no cost.  

In letters despatched Thursday to the 5 largest Health insurers and 4 largest pharmacy profit managers first shared with The Hill, Rep. Jamie Raskin (D-Md.) requested for Information on how the businesses plan to answer federal steering designed to enhance no-cost entry to contraception. 

Adopting the steering “is significant to making sure that tens of millions of ladies of reproductive age have elevated entry to no-cost contraception—one thing that’s notably necessary as Republicans proceed to enact stringent bans on abortion throughout the nation,” Raskin mentioned within the letters. 

The letters have been despatched to Aetna, Cigna, Elevance Health, Humana, United Healthcare, CVS Caremark, Specific Scripts, Optum Rx and Prime Therapeutics. The Hill has reached out to all the corporations for remark.

The steering from federal Health officers in January inspired insurers to cowl with out cost-sharing all Meals and Drug Administration-approved contraceptive merchandise that do not need a therapeutic equal. 

The steering would permit Health plans and PBMs to prioritize using generic prescription drugs the place doable, whereas making certain that sufferers have entry with out price sharing to merchandise that don’t but have a generic model. 

In all 50 states, the Inexpensive Care Act ensures protection of ladies’s preventive companies, together with free contraception and contraceptive counseling. There are 18 contraceptive strategies authorised by the Meals and Drug Administration, however the regulation requires insurers to cowl just one product per class.  

A 2023 employees report from Raskin’s workplace discovered that many sufferers lined by 5 of the biggest Health insurers and 4 of the biggest PBMs impose protection exclusions and different restrictions on contraception merchandise, opposite to the ACA.