Provides for the dispensing of emergency contraception under certain circumstances and conditions

BILL NUMBER:S4365

Title of bill

An act to amend the insurance law and the public health law, in relation to providing for dispensing emergency contraception under certain conditions

Purpose or general idea of bill

To make emergency contraception drugs purchased over-the-counter without a medical prescription covered by insurance companies.

Summary of specific provisions

Section 1 adds a new subsection (n) to section 3216 of the insurance law, to provide that emergency contraception drugs purchased over-the-counter without a medical prescription shall be covered by individually purchased insurance plans.

Section 2 adds a new subsection (t) to section 3221 of the insurance law, to provide that emergency contraception drugs purchased over-the-counter without a medical prescription shall be covered by group purchased insurance plans, such as insurance plans provided through employment.

Section 3 adds a new subsection (n) to section 4304 of the insurance law, to provide that emergency contraception drugs purchased over-the-counter without a medical prescription shall be covered by individual insurance plans contracted with private corporations, such as insurance plans provided by non-profit organizations.

Section 4 adds a new paragraph (k) to subdivision 1 of section 207 of the public health law, to include emergency contraception within the Health Care and Wellness Education and Outreach Program. The Department of Health may conduct education and outreach programs for consumers, patients, educators, including but not limited to elementary and secondary school educators, and health care providers relating to any health care matters the commissioner deems appropriate.

Section 5 provides the effective date.

Justification

The Federal government has made the over-the-counter purchase of certain emergency contraception (EC) drugs available to all ages. Currently, women must pay 'out-of-pocket' when purchasing emergency contraceptive drugs over-the-counter. This is cost prohibitive for some, especially for young, underage women or women with lower incomes.

However, under the Federal Affordable Care Act, insurance companies are required to cover EC drugs approved by the U.S. Food and Drug Administration without cost sharing when the purchase is made under a prescription. EC is a time-sensitive medication and is most effective in preventing pregnancy the sooner it is taken after unprotected sex, birth control failure, or sexual assault. When women cannot obtain a prescription in a timely manner, such as on the weekend, they must purchase EC over-the-counter. As a result women must pay "out-of-pocket' when purchasing EC drugs over-the-counter even though their insurance covers the drug with a prescription.

This bill will require health insurance companies to provide coverage for EC drugs purchased over-the-counter, including those drugs legally purchased without a medical prescription. It therefore fulfills the goal of allowing women to access the drug through their insurance without cost-sharing.

Prior legislative history

This is a new bill.

Fiscal implications

None to the state.

Effective date

This act shall take effect 180 days after it shall have become a law; and sections one, two and three of this act shall apply to policies and contracts issued, renewed, modified, altered or amended on or after such effective date.