Nancy H. Nielsen, MD, PhD

Medical policy expert Nancy H. Nielsen, MD ’76, PhD, predicts the Hobby Lobby ruling will cause more employers to opt out of contraception coverage.

US Coverage of Essential Benefits Intact, Despite Birth Control Ruling

Published July 1, 2014

“The justices went out of their way to say their decision doesn’t extend to other health insurance mandates, like blood transfusions and vaccinations, so I don’t think this will have bigger implications beyond the contraception issue.”
Nancy H. Nielsen, MD, PhD
Senior associate dean for health policy

Providing essential health care benefits remains a fundamental tenet of the Affordable Care Act, despite a Supreme Court ruling that some employers do not have to comply with the law’s birth control mandate, says University at Buffalo medical policy expert Nancy H. Nielsen, MD, PhD, senior associate dean for health policy.

According to the court’s 5-4 decision, closely held for-profit companies may refuse to cover certain birth control methods if they conflict with the owner’s religious beliefs.

Decision Does Not Affect Other Mandates

“The justices went out of their way to say their Burwell v. Hobby Lobby Stores decision doesn’t extend to other health insurance mandates, like blood transfusions and vaccinations,” says Nielsen, “so I don’t think this will have bigger implications beyond the contraception issue.” 

Nonetheless, she predicts “the number of employers opting out of contraception coverage will probably grow.”

Contraception Part of Required Preventive Services

“This case was a challenge to part of the health care law that requires coverage for specified essential preventive services — including contraception — without copays or deductibles,” says Nielsen, past president of the American Medical Association.

The provision applies only to insurance plans that emerged or changed significantly since 2010; it does not affect “grandfathered” plans in place prior to the act’s passage, unless major changes were made to benefits or copays, Nielsen notes.

The U.S. Department of Health and Human Services determined the list of essential benefits, based on criteria from an Institute of Medicine advisory panel.