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Business and Policy Areas
Business and Policy Areas

ACA Rules on Contraceptive Services Finalized

July 30, 2015

Final rules that allow women to have access to recommended preventive services, including contraceptive services, at no additional cost as required by the Affordable Care Act (ACA) were published on July 14. The final rules adopt interim rules published in August 2014, confirming the existing accommodation for eligible religious nonprofits and an alternative pathway for those employers to provide notice of their objection to covering contraceptive services. The rule also provides the same accommodations to certain closely held for-profit entities. This rule is the sixth, and presumably the last, final or interim final rule published on contraceptive coverage under the ACA over the last five years and takes effect September 14, 2015.

Last year, the Department of Health and Human Services (HHS),  the Department of Labor (DoL), and the Department of the Treasury issued interim final rules that permit certain employers with religious objections to covering contraceptive services to seek an accommodation from contracting, providing, paying for, or referring such services.

Under the final rules, eligible organizations may notify HHS in writing of their religious objection to providing contraception coverage as an alternative to filling out the form provided by the DoL to provide to their issuer or third-party administrator. HHS and the DoL will then notify insurers and third-party administrators of the organization's objection so that enrollees in plans of such organizations receive separate payments for contraceptive services, at no additional cost to the enrollee or organization and with no involvement by the organization.

Following the Supreme Court's decision last year in Burwell v. Hobby Lobby, the final rules expand the above accommodations to closely held for-profit entities. Relying on a federal tax law definition, the rules describe a closely held for-profit entity as "an entity that is not publicly traded and that has an ownership structure under which more than 50 percent of the organization's ownership interest is owned by five or fewer individuals, or an entity with a substantially similar ownership structure." For purposes of this definition, all of the ownership interests held by members of a family are treated as being owned by a single individual.


Mary Bachinger
Director, Tax Policy