Mandates are “not the most rational way to build a benefit package,” says Corlette.

To discourage states from passing mandates that go beyond essential health benefits requirements, the law requires states, not insurers, to cover the cost of mandates passed after 2011 that apply to individual and small group plans sold on or off the state health insurance marketplaces.

The federal guarantee does not require similar coverage for vasectomy or male condoms.

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Number of states mandating insurance video

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In addition, the federal government has established an “accommodation” that allows other nonprofits and closely held for-profit firms with religious objections to opt out of paying for, arranging for or communicating about contraceptive coverage; under that accommodation, the affected employees and dependents must still receive contraceptive coverage from the insurer at no additional cost.

Ψ The following states have enacted laws that will not apply to insurance plans until a later date: Colorado (January 2019), Maine (January 2019), Maryland (January 2018), Massachusetts (August 2018), Nevada (January 2018), Oregon (January 2019), Virginia (January 2018) and Washington (January 2018).Ω A 2016 law, that goes into effect in January 2018, will require coverage of male sterilization, prohibit cost-sharing, prohibit restrictions and delays, require coverage of over-the-counter methods, and require coverage of an extended supply of a method.€ The state's law allows pharmacists to dispense the full amount of a prescription at one time, including contraception, but there is no requirement that the health plan cover the cost of accessing a year's worth of contraceptives at one time.

In 26 states, autism coverage is part of the essential health benefits, typically because coverage was mandated before 2012 and so was included in that state’s “benchmark” plan that sets the standard for coverage there. “For the most part, the states that have passed autism mandates post Dec.

31, 2011, have excluded ACA-compliant plans from the mandate,” Unumb says.If a mandate increases a plan’s premium, states will be on the hook for the additional premium cost that’s attributable to the mandate.The payment requirement is waived until 2016, says Kelly Brantley, a senior manager at Avalere Health who’s looked at mandates related to infertility coverage, and regulations describing how the process will work haven’t yet been issued.(Self-funded plans, used by many large employers to pay employee claims directly rather than buying insurance for that purpose, aren’t bound by state mandates.) That’s what’s happening with state mandates related to autism coverage, says Lorri Unumb, vice president of state government affairs at Autism Speaks, an advocacy group.By the group’s count, 37 states and the District of Columbia have mandates requiring autism coverage.States have taken different approaches to structuring new mandates so they don’t have to pay for them, says Justin Giovannelli, a research fellow at Georgetown’s Center on Health Insurance Reforms, who has examined state laws in this area.