![\"https:\/\/commons.wikimedia.org\/wiki\/File%3APackage_of_Lutera_Birth_Control_Pills.jpg;](\"https:\/\/wp-media.patheos.com\/blogs\/sites\/533\/2016\/12\/800px-Package_of_Lutera_Birth_Control_Pills.jpg\")
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Here\u2019s a piece of legislation which got pretty much zero coverage at the time it was passed: \u00a0Illinois Public Act 099-0672. \u00a0OK, the non-zero coverage consists of an article in the Journal-Star<\/a>\u00a0from Peoria. \u00a0Nothing, from memory and from google, in the Chicago Tribune; only the other day, as an offhand reference in a Tribune article about women fearful of losing their \u201cfree\u201d (no out of pocket cost) contraceptives, did I read a mention that Illinois women with true insured plans, are not impacted because of this law.<\/p>\n The law (text in full here<\/a>) is largely a codification of the federal government\u2019s contraceptive mandate, since the latter is a matter of regulation, not legislation, though, as state legislation, it can only apply to health insurance plans, not self-insured health benefits offered by large employers. \u00a0It does take the requirement further, though: \u00a0it requires insurance companies to cover every formulation of a contraceptive; that is, an insurer cannot include only some types of birth control pills, but must cover each and every type, though it is permitted, among pills which are \u201ctherapeutically equivalent,\u201d to include only one on its formulary. \u00a0(This seems to be a reaction to insurers limiting benefits to less costly pills and\/or negotiating with pharmas to get the best pricing.) \u00a0What\u2019s more, if I read the text correctly, even in cases where two drugs are deemed equivalent, a patient can still, based on a doctor\u2019s determination of \u201cmedical necessity,\u201d demand a specific brand, or, more likely, demand brand-name rather than generic-equivalent pills.<\/p>\n But here are some other quirks:<\/p>\n All contraceptive drugs, devices, and other\u00a0products approved by the United States Food and Drug\u00a0Administration [are covered]. This includes all over-the-counter\u00a0contraceptive drugs, devices, and products approved by the\u00a0United States Food and Drug Administration, excluding male\u00a0condoms.<\/p><\/blockquote>\n Now, this isn\u2019t particularly new \u2014 here\u2019s the list (from Wikipedia, as a handy summary<\/a>) of what\u2019s in the HHS mandate:<\/p>\n sterilization surgery, surgical sterilization implant, implantable rod, copper intrauterine device, IUDs with progestin (a hormone), shot\/injection, oral contraceptives (the pill), with estrogen and progestin, oral contraceptives with progestin only, oral contraceptives, known as extended or continuous use that delay menstruation, the patch, vaginal contraceptive ring, diaphragm, sponge, cervical cap, female condom, spermicide, emergency contraception (Plan B\/morning-after pill), and emergency contraception (a different pill called Ella).<\/p><\/blockquote>\n But there are a couple interesting differences: \u00a0the Illinois bill specifically includes \u201csterilization,\u201d but then excludes \u201csurgical sterilization,\u201d which seems to mean that the only form of sterilization permitted is the \u201cEssure\u201d implant. \u00a0Why did the lawmakers make this decision? \u00a0Perhaps they wanted to continue to exclude vasectomies, but wanted\u00a0the law to be gender-neutral, so they excluded tubal ligations as well. \u00a0Certainly, since this is a state law regulating insurance, they didn\u2019t need to base this on \u201cpreventative care\u201d provisions, which was the original basis for the HHS mandate only covering benefits for women, because only they can claim a health impact due to an unplanned pregnancy \u2013 for men, there is no direct health consequence to a partner\u2019s pregnancy. \u00a0(And recall that the Institute of Medicine<\/a> claimed that, while being pregnant per se was not a matter of ill health, unintended pregnancies were associated with lack of prenatal care and poor outcomes, so that the use of contraceptives to prevent unintended pregnancy was a true health-preservation measure.) \u00a0At the state level, and in the context of legislation, not being bound by a law that requires a \u201cpreventative\u201d rationale for the mandates, lawmakers were not limited. \u00a0In fact, the original text did not have a specific exclusion of male condoms, and this was only added later<\/a>. \u00a0Maybe this was along the lines of a drafting error \u2014 I don\u2019t know. \u00a0But it is curious.<\/p>\n And here\u2019s another gotta-love-Illinois bit:<\/p>\n If, at any time, the Secretary of the United States\u00a0Department of Health and Human Services, or its successor\u00a0agency, promulgates rules or regulations to be published in the\u00a0Federal Register or publishes a comment in the Federal Register\u00a0or issues an opinion, guidance, or other action that would\u00a0require the State, pursuant to any provision of the Patient\u00a0Protection and Affordable Care Act (Public Law 111\u2013148),\u00a0including, but not limited to, 42 U.S.C. 18031(d)(3)(B) or any\u00a0successor provision, to defray the cost of any coverage\u00a0outlined in this subsection (a), then this subsection (a) is\u00a0inoperative with respect to all coverage outlined in this\u00a0subsection (a) other than that authorized under Section 1902 of\u00a0the Social Security Act, 42 U.S.C. 1396a, and the State shall\u00a0not assume any obligation for the cost of the coverage set\u00a0forth in this subsection (a).<\/p><\/blockquote>\n Yes, I\u2019m not clear exactly on the scenario that they\u2019re envisioning here, except, of course, that this is saying that, if the state, rather than insurance companies\u2019 customers, are on the hook, then never mind.<\/p>\n And one more interesting bit: \u00a0at several points, consultations on natural family planning are explicitly listed as being included. \u00a0But does this mean that an individual wanting to engage the services of an NFP instructor, either for a series of classes, or one-on-one consultations and chart interpretation, could file for reimbursement? \u00a0And could an NFP user who adapts a device approved by the FDA for other purposes (e.g., the ClearBlue fertility monitor and test sticks), parse the language, and say, \u201cit is a contraceptive device, when used as I do, and it is FDA approved, just not \u2018FDA-approved as a contraceptive device'\u201d to seek reimbursement?<\/p>\n So, anyway, just a little tidbit to share with you. \u00a0Is it the most important thing in the world? \u00a0No. \u00a0But there you go.<\/p>\n \u00a0<\/p>\n Image: \u00a0https:\/\/commons.wikimedia.org\/wiki\/File%3APackage_of_Lutera_Birth_Control_Pills.jpg; By ParentingPatch (Own work) [CC BY-SA 3.0 (http:\/\/creativecommons.org\/licenses\/by-sa\/3.0)], via Wikimedia Commons<\/p>\n<\/body><\/html>\n","protected":false},"excerpt":{"rendered":" Here\u2019s a piece of legislation which got pretty much zero coverage at the time it was passed: \u00a0Illinois Public Act 099-0672. \u00a0OK, the non-zero coverage consists of an article in the Journal-Star\u00a0from Peoria. \u00a0Nothing, from memory and from google, in the Chicago Tribune; only the other day, as an offhand reference in a Tribune article […]<\/p>\n","protected":false},"author":2209,"featured_media":5727,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[269],"class_list":["post-5726","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-contraception"],"yoast_head":"\n