No-cost birth control, now the norm, faces court challenges
Law Journals
Millions of American women are receiving birth control at no cost to them through workplace health plans, the result of the Obama-era Affordable Care Act, which expanded access to contraception.
The Trump administration sought to allow more employers to opt out because of religious or moral objections. But its plans were put on hold by two federal judges, one in Pennsylvania and the other in California, in cases that could eventually reach the Supreme Court.
The judges blocked the Trump policy from going into effect while legal challenges from state attorneys general continue.
Here's a look at some of the issues behind the confrontation over birth control, politics and religious beliefs:
Well into the 1990s many states did not require health insurance plans to cover birth control for women.
"Plans were covering Viagra, and they weren't covering birth control," said Alina Salganicoff, director of women's health policy with the nonpartisan Kaiser Family Foundation.
By the time President Barack Obama's health law passed in 2010, employers and insurers largely began covering birth control as an important part of health care for women.
The ACA took that a couple of steps further. It required most insurance plans to cover a broad range of preventive services, including vaccinations and cancer screenings, but also women's health services. And it also required such preventive services to be offered at no charge.
Employers and insurers were required to cover at least one of each class of birth control approved by the Food and Drug Administration. That included costly long-acting contraceptives, generally more effective than birth control pills.
It's estimated that 55 million to more than 62 million women now receive birth control at no cost, with only a small share paying for contraception.
"The irony I find about this battle is that in the period of time this policy has been in effect, teen pregnancies have gone way down and the number of abortions has gone way down," said Kathleen Sebelius, Health and Human Services secretary under Obama.
While those rates were already going down before the health law, the trend does continue.
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Workers’ Compensation Subrogation of Administrative Fees and Costs
When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.
In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.
In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.