Governor Extends Prescription Contraceptive Benefits to Six Months

Lilo H. Stainton | December 18, 2017 | Health Care
New law makes it simpler for low- and middle-income women — who may face time constraints — to prevent gaps in birth-control use

Starting in April, many New Jersey women will be able to extend their one-time supply of prescription birth control to six months at no personal cost, thanks to a new law that essentially doubles the amount currently available.

Gov. Chris Christie signed bipartisan legislation on Friday that requires health insurance plans doing business in the Garden State to cover up to six months of birth control pills or other female prescription contraceptives, after an initial three-month supply, at one time. Federal law already prohibits out-of-pocket costs for these products.

Advocates hope the change will help reduce the number of unplanned and unwanted pregnancies, a shift that can strengthen the health and economic position of women and families in general. More than one-third of pregnancies in America were unplanned, according to a review of 2010 data by the Guttmacher Institute, which studies reproduction; in New Jersey, more than half the births were unplanned.

“The purpose of this law is to increase access to birth control, and by providing this six-month supply we will ensure that women can plan longer-term. Women today are often busy with work and managing child care, which makes picking up a monthly prescription impractical,” said Sen. Shirley Turner (D-Mercer), a longtime advocate for expanding birth control.

“Women should have timely access to contraception in order to protect their health, plan their families and their future, and this law will help with that effort,” said Turner, who championed the bill with Sen. Diane Allen (R-Burlington). The Senate passed the legislation with unanimous support earlier this month.

Limited supply

Currently, many health insurance companies limit their coverage, without cost-sharing, of birth control to a one- or three-month supply, Turner said, which can lead to unwanted gaps in birth control use and an increase in unintended pregnancies. Inadequate supplies of birth control are of particular concern for low- and middle-income women who may have unpredictable work hours, difficulty accessing transportation, or other barriers preventing them from getting to a pharmacy, she added

According to Guttmacher, the law — which takes effect in 90 days — enables New Jersey to join seven other states, including New York, that already require long-term coverage of these prescriptions. Maryland, Virginia, and a handful of other states have also adopted similar policies that will come online in the coming year.

New Jersey, with a strong tradition of mandated insurance coverage for a variety of procedures and services, was among more than two-dozen states that have long insisted health plans cover prescription contraceptives. The 2010 Affordable Care Act, or Obamacare, forced insurance providers nationwide to include this benefit, without charging patients anything out-of-pocket.

No surprise

Christie’s approval of the plan to extend coverage did not come as a surprise; in July, he vetoed a previous version of the bill that would have required up to a year’s worth of coverage for contraceptive prescriptions. Christie said he has worked to support women’s healthcare — a point of some debate, given his refusal to provide additional funding for women’s healthcare services at clinics like Planned Parenthood — but the governor said the bill, as originally drafted, would go too far.

“While I support the bill’s intention to increase access to medically-appropriate prescription drugs, including contraceptives, I am concerned that the bill would lead to unnecessary drug waste and could potentially limit patient choice in this area. Moreover, mandating twelve full months of coverage with no patient cost-sharing, regardless of where an individual is in their policy term, affords special treatment to one particular class of drugs and will unfairly shift the cost to policyholders in the form of unnecessary premium increases,” he warned in his July 31 veto message.

The law also reflects a request from Christie that allowed insurance companies to provide less than six-months worth of drugs if that supply would lapse into a new coverage year. The change applies to all insurance plans governed by state law, including those available to state and local public workers, but would not impact self-insured plans provided by large corporations.

The measure, which dates back to 2015, was revised to reflect the governor’s changes and passed the Assembly this summer with little objection. The Assembly version (A-2297, which was adopted as final), was led by Assemblywoman Valerie Vainieri Huttle (D-Bergen), who chairs the human services committee, and Assemblywoman Shavonda Sumter, (D-Passaic.) The Senate returned its attention to the bill in October, when it cleared the health committee in advance of the full vote.