Despite questions raised by the Supreme Court decision in the Hobby Lobby case, women in most health plans will still be able to get their birth control covered with no out-of-pocket expenses.
The court ruling did not change the health law's requirement that preventive care services, including all Food and Drug Administration-approved forms of contraception for women, be provided by most health plans to customers without cost. The 5-4 decision said that only certain "closely held" firms that assert a religious objection to the birth control mandate can't be required to provide contraceptive coverage if they offer insurance to their workers.
Moreover, many firms see a benefit in providing coverage for contraceptives, says Adam Sonfield, a senior public policy associate at the Guttmacher Institute, a research and policy organization that focuses on reproductive health.
"There are so many incentives for companies to cover contraception," says Sonfield, including cost savings to insurers and self-funded employer plans because birth control is cheaper to cover than maternity and delivery.
Most companies provided contraceptive coverage even before the Affordable Care Act passed: 85 percent of companies with more than 200 workers and 63 percent of companies did overall, according to the Kaiser Family Foundation's 2010 annual employer health benefits survey.
Before the contraceptive mandate took effect, companies offering plans could generally choose which contraceptive methods they would cover. In the Supreme Court case, for example, the Hobby Lobby craft store chain offered workers birth control coverage but objected to two IUDs and emergency methods such as Plan B and Ella that can prevent pregnancy if taken shortly after unprotected sex. The chain's owners argued that those methods induce abortions, an argument that many scientists dispute.
The health law does allow some exemptions to the mandate. Those are for plans that were in place when the law took effect and have not changed substantially, and plans covering religious employers such as churches.
In addition, nonprofit religious organizations that object to covering birth control, such as some Catholic charities or universities, can elect instead to have their insurer or third-party administrator pay for the workers' contraceptive coverage. However, that accommodation is being litigated, and the outcome for female employees of those sorts of organizations is not clear.