Vermont birth control bill braces for Obamacare repeal

MONTPELIER – Some Vermont lawmakers are trying to reinforce the state's birth control insurance mandates with an eye on the 2016 national elections.

A bill moving through the Vermont House of Representatives would retain the birth control mandate in the federal Affordable Care Act, requiring health insurance plans to provide contraceptives and sterilization at no cost to patients — even if Congress repeals the law.

“Sometimes it’s good to have belts and suspenders,” said Rep. Ann Pugh, D-South Burlington, the lead sponsor of H.620, noting that federal politics can change.

U.S. House Republicans have tried numerous times to overturn the Affordable Care Act, also known as Obamacare, but have been unable to break through President Barack Obama’s veto.

“Should there be a president unsupportive of the ACA, we don’t want Vermonters to lose those benefits,” said Anne Burmeister, who has backed the bill in Montpelier on behalf of Planned Parenthood of Northern New England.

The fortress against a Republican president is part of a larger package that seeks to expand Vermonters’ access to birth control.

A handful of Vermont Republicans, at least, have already said they support the bill.

“You don’t have to like all of Obamacare to support access to birth control for women,” said Rep. Patti Komline, R-Dorset, who joined a group of Democrats and an independent member to sponsor the bill.

But Vermont's proposal has also spurred religious liberty concerns. The Roman Catholic Diocese of Burlington requested an exemption in the bill for religious employers on Thursday.

"Without a religious opt-out, organizations such as the Roman Catholic Diocese of Burlington will be forced to pay for procedures and prescriptions that violate their deeply held religious beliefs," said Carrie Handy, Respect Life coordinator for the diocese, in written testimony to the House Health Care Committee.

Handy wrote the Roman Catholic Diocese of Burlington would face an impossible choice between paying for coverage they find objectionable and dropping health coverage altogether.

Burmeister, of Planned Parenthood, argued the House bill would impose no new burdens on religious employers in Vermont, and that the Roman Catholic Diocese of Burlington testimony was asking for a new exemption.

Nearly half of Vermont pregnancies are unplanned, according to the state Department of Health. The state is trying to reduce the unplanned pregnancy rate to 35 percent — a 15-percentage-point drop — by 2020.

“Unintended pregnancy really is associated with some poorer health outcomes,” said state Health Commissioner Harry Chen.

Many of those pregnancies rely on state funds. Medicaid spent $8.9 million on unintended pregnancies in fiscal 2015, said Ashley Berliner, director of health care policy and planning at the Agency of Human Services.

The House bill would require health insurance and Medicaid to cover FDA-approved birth control, sterilization procedures, and related education and counseling services without any co-pay or cost-sharing. Vermont would add vasectomies to the list of services that health insurance plans must cover at no cost, with the exception of high-deductible plans.

“Family planning is not just a women’s issue,” Pugh said.

Lawmakers are also interested in encouraging long-acting reversible contraception, such as implants and intrauterine devices, as one of the most effective ways to prevent pregnancy. The bill would ask the state to raise Medicaid reimbursement rates for those devices to encourage health care providers to have them in stock to offer to patients.

It’s unclear how much a higher reimbursement for long-term contraception would cost Vermont. The House Appropriations Committee has been tasked with setting a dollar amount.

In addition, the bill would give patients the option of obtaining a 12-month supply of prescribed contraceptives, rather than having to return to a pharmacy every 90 days or so.

BlueCross BlueShield of Vermont, which supports the bill overall, has told lawmakers that the 12-month birth control provision and no-cost vasectomies might impact insurance premiums.

The potential financial impact piqued the interest of Rep. Anne Donahue, R-Northfield, a member of the House Health Care Committee that approved the bill.

“I support anything we can do to help provide access to contraceptives for folks who want them,” Donahue said. “What the best ways are for funding and who pays, I think, gets more challenging to parse out.”

Contact April Burbank at 802-660-1863 or aburbank@freepressmedia.com. Follow her on Twitter atwww.twitter.com/AprilBurbank