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Courts block defunding of Planned Parenthood

Posted on October 23, 2012 | No Comments

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Federal judges Friday and today ruled that Arizona and Indiana, respectively, cannot halt public funding to Planned Parenthood for general healthcare services that don’t include abortion.

In Arizona, the preliminary injunction by U.S. District Judge Neil Wake bars the state from applying a new state anti-abortion law to Planned Parenthood Arizona. The state already prohibits public funding for most abortions. The new law, passed earlier this year but not yet implemented, would go so far as to bar public funding for general health care services provided by entities that also provide abortions. Supporters of the new law said that public funding for agencies like Planned Parenthood indirectly subsidizes abortions. Judge Wake ruled that the subsidies could in no way fund abortions because Medicaid reimbursements to Planned Parenthood Arizona cover only about half of the costs and thus, the Judge ruled that, “there is no excess funding that could be used to subsidize abortions.” The Judge found that it is in the best interest of Arizona to block the law’s implementation to prevent some 3,000 patients from being denied health care delivery from their chosen health care providers.

In Indiana, a federal appeals court similarly ruled that the state cannot cut off funding for Planned Parenthood just because they provide abortions, amongst many other health care services. The 7th U.S. Circuit Court of Appeals in Chicago upheld a lower court decision that found that Indiana cannot enforce a state law that barred abortion providers from collecting Medicaid reimbursements for any health care services provided.

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The Center for Consumer Information and Insurance Oversight (CCIIO) of the U.S. Department of Health and Human Services (HHS) has issued a bulletin providing further guidance on the coverage of contraceptive services without cost sharing. In an August 2011 interim final rule (IFR), HHS required non-grandfathered health plans to provide such coverage beginning August 1, 2012, but also included a temporary safe harbor from enforcement in the rule for employers objecting based on religious reasons. In this latest guidance, CCIIO clarifies what types of employers are eligible for the safe harbor and when specifically it can be invoked. To qualify for the temporary enforcement safe harbor and thus be excluded from the contraceptive coverage mandate, organizations must be nonprofits, from February 10, 2012 onward, they must not have provided contraceptive coverage due to religious beliefs; they are mandated to disclose to participants that contraceptives are not covered; and they must self-certify that they satisfy the three aforementioned criteria. The Obama administration noted that the ACA provision would provide women with access to preventive services, including contraceptives, without cost sharing, while ensuring nonprofit religious organizations are not forced to cover any contraceptive service to which they object.
Today, 47 million women receive access to eight new preventive health care services without copay. The Affordable Care Act (ACA) provision requires plans to cover the following services: * Well-woman visits. * Gestational diabetes screening that helps protect pregnant women from one of the most serious pregnancy-related diseases. * Domestic and interpersonal violence screening and counseling. * FDA-approved contraceptive methods, and contraceptive education and counseling. * Breastfeeding support, supplies, and counseling. * HPV DNA testing, for women 30 or older. * Sexually transmitted infections counseling for sexually-active women. * HIV screening and counseling for sexually-active women. The aforementioned covered services are based on recommendations from the Institute of Medicine, which relied on independent physicians, nurses, scientists, and other experts as well as evidence-based research to develop its recommendations. Group health plans and plans that have maintained grandfathered status are not required to cover the new services. Additionally, certain religious institutions are also exempt.
On Friday, President Obama announced that the administration would compromise on the preventive services final rule. The final rule, an update to the interim final rule released in August, would have required religiously affiliated entities to cover contraceptive care without any cost-sharing requirements. The new final rules mandate that nonprofit organizations affiliated with religious institutions that do not cover contraception based on their beliefs will not have to include it in their coverage. However, health insurers that provide the policies used by those nonprofit religious affiliates, which include educational institutions, hospitals, and charities, are required to offer separate insurance policy “riders” that cover contraceptive care at no additional cost. The announcement came after many Catholic organizations and Republicans had strongly objected to the original final rule that the Department of Health and Human Services had announced on January 20th.
US Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that religious non-profit employers who do not currently offer contraceptive coverage to their employees will have an additional year to comply with the preventive services requirement set forth in an earlier Interim Final Rule (IFR). The earlier rule requires, that as of August 1, 2012, all employers except for churches must include contraception among the free preventive services covered in the insurance plans they offer to employees. The new announcement allows those employers who have religious objections an additional year to comply with the requirement. For more information on preventive services, click here.
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Recent federal regulations requiring insurance coverage of contraception have generated controversy, especially as applied to religious employers. The requirement stems from an ACA provision requiring insurance coverage of preventive services. Section 2713 of the Public Health Service Act, as added by Section 1001 of the Patient Protection and Affordable Care Act (ACA), requires group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage without cost-sharing for certain preventive services, including preventive treatments and services for women recommended by The Health Resources and Services Administration (HRSA) in guidelines. The preventive services provisions of the Act...