The enactment of a new contraception coverage mandate could end up costing employers, according to a new survey.
The Affordable Care Act of 2010 requires that insurance plans provide patients with contraceptives at no cost. The rationale behind the mandate, which takes effect in August, is that eliminating unwanted pregnancies will ultimately reduce overall health care costs.
But a new survey of pharmacy directors by Madison-based market research firm Reimbursement Intelligence found half of payers expect per-member, per-month pharmacy costs to rise as a result of the mandate. Only 7 percent said the higher pharmacy costs would be offset by lower medical costs.
“So their employees will have cost savings, but in the end, it will cost the employer more,” said Rhonda Greenapple, Reimbursement Intelligence CEO.
Survey respondents said they already offer contraception at a nominal co-pay rate, and said less than 15 percent of their employer customers currently exclude birth control coverage from their plans.
Greenapple said survey participants expressed skepticism about the potential for net health care cost savings, in part because people frequently switch employers and insurers. Thus, an employee who benefits from one insurer’s preventative care spending might be part of a different insurance plan by the time the long-term savings made possible by the preventative care are realized.
Greenapple also noted birth control isn’t the only option when it comes to unintended pregnancies.
“The concept is that you’re saving unintended pregnancies (by covering contraception), but on the other hand, if you look at it, a significant number of those plans also cover abortion, which is another option,” she said.
Fifteen pharmacy directors, representing plans with tens of millions of insured patients, took part in the survey.
Greenapple said she didn’t come at the survey with a political agenda, but only with the goal of finding out what payers are thinking about the controversial issue.
What surprised her, she said, was how little payers are thinking about it. The survey found only about one quarter of respondents had a plan in place to meet the August deadline, though most said they intend on implementing a plan within the next three to six months.
But Greenapple said spending on contraceptives is still a relatively minor piece of insurers’ budgets. Most contraceptives are available in generic form, she said, and the price of contraceptives pales in comparison to drugs for diseases such as cancer.