Vermont: Governor Protects and Expands Access to Birth Control Benefits

Governor Peter Shumlin (D) expanded birth control coverage options and codified existing federal mandates by signing into law H.620, which requires insurers to cover all FDA-approved forms of contraceptives without cost-sharing to insulate Vermonters from “efforts to undermine important birth control provisions in the Affordable Care Act.” Notably, the bill establishes a special enrollment period enabling women who become pregnant to sign up for health insurance on Vermont Health Connect outside of open enrollment. Additionally, the bill permits women to obtain up to 12 months of hormonal contraceptive methods following one physician visit and ensures vasectomies are available to men without cost-sharing, making Vermont the first state to extend no-cost birth control protections to men. Finally, the bill increases Medicaid reimbursement rates for long acting reversible contraceptives such as intrauterine devices. The law is scheduled to take effect on July 1.

Post-ACA Marketplace and Medicaid Enrollees Report Access to Care and Satisfaction With Coverage

A new survey from the Commonwealth Fund found that the ACA’s coverage expansions are ending long periods of uninsurance for many of the newly enrolled, with 45% of adults in Marketplace plans and 62% of adults newly covered by Medicaid having been uninsured prior to enrollment. Over half of these adults had been uninsured for more than two years. During this same period, the share of adults enrolled in employer sponsored insurance (ESI) has remained stable (56% of adults in 2013 to 53% in 2016), suggesting that the overall growth in Marketplace and Medicaid coverage is not due to substantial shifts from ESI. The Commonwealth Fund’s survey, now in its fourth wave, indicates that each year since the ACA’s coverage expansions, majorities of new enrollees have reported they are very or somewhat satisfied with their health insurance—77% of Marketplace enrollees and 88% of Medicaid enrollees according to the most recent data. Access to care has also improved. Seventy-two percent of new enrollees report using their coverage to go to a doctor or other provider or to fill a prescription; 61% of these enrollees report they would not have been able to afford or access that care prior to enrolling. The survey was based on a sample of working-age adults, roughly 18% of whom have new Marketplace or Medicaid coverage.