Overview
Title
To amend title XXVII of the Public Health Service Act to require group health plans and health insurance issuers offering group or individual health insurance coverage to permit enrollees to obtain a 365-day supply of contraceptives.
ELI5 AI
S. 1239 is a plan to make it easier for people to get a whole year's worth of birth control pills at once through their health insurance, starting in 2026. This change means that people won't need to keep going back to get more every month.
Summary AI
S. 1239 seeks to amend the Public Health Service Act to allow people enrolled in group health plans or those with individual health insurance to obtain up to a one-year supply of contraceptives at once. This change is aimed at making it easier for individuals to access and manage their contraceptive needs without additional costs. The amendment will take effect for plan years starting on or after January 1, 2026, and requires outreach efforts from relevant government departments to inform health care providers and enrollees about this new benefit.
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AnalysisAI
General Summary of the Bill
The proposed legislation, known as the "Convenient Contraception Act," aims to amend the Public Health Service Act. The bill, S. 1239, seeks to enable individuals enrolled in group or individual health insurance plans to obtain up to a 365-day supply of contraceptives in one transaction, removing any additional cost-sharing requirements. This change is set to take effect in January 2026. Additionally, the bill mandates that health-related government officials conduct outreach activities to inform health plan enrollees and providers about these new benefits within 90 days of the bill's enactment.
Summary of Significant Issues
There are several notable issues within the bill that may require further clarification:
Lack of Clarity on "The Secretary": The bill frequently references "the Secretary" without specifying which Secretary is being referred to, though it later involves the Secretaries of Health and Human Services, Labor, and the Treasury. This could lead to confusion over responsibility.
Ambiguity in Benefit Provisions: The language surrounding "the total day supply (not to exceed a 365-day supply)" is vague. It does not explicitly define if individuals can choose any amount up to 365 days, opening the door for varied interpretations by insurers and enrollees.
Undefined Outreach Activities: The requirement for outreach activities is also vaguely defined, with no specific methods or standards provided for how these activities should be carried out, which might result in inconsistent execution.
No Designated Resources for Outreach: There is no mention of an allocated budget or resources for the mandated outreach, potentially leading to financial strain and hindering effective communication.
Potential Impact on Current Regulations: The bill mentions compliance with existing laws but does not delve into possible impacts on current regulations or unforeseen consequences.
Impact on the Public
The bill broadly aims to make access to contraceptives more convenient and potentially less costly for individuals by allowing a year-long supply to be obtained at once. This could lead to increased utilization of contraceptives due to added convenience and reduced financial barriers since no additional cost-sharing applies. Ensuring contraceptive access with minimal barriers can contribute to improved family planning and reproductive health outcomes.
Impact on Specific Stakeholders
Positive Impacts
Enrollees: The most significant benefit would be to individuals who use contraceptives, as they will have the flexibility to obtain their preferred contraceptive method for an entire year in one purchase without bearing any additional cost.
Healthcare Providers: Providers may find patient compliance in contraceptive use improved, as patients can now ensure they have a steady supply.
Potential Challenges
Insurance Issuers: Health insurance companies might face logistical challenges in implementing the 365-day supply option and adjusting their current systems to accommodate this new requirement.
Government Agencies: Agencies tasked with the outreach activities might find themselves under pressure to execute effective campaigns without designated resources or clear guidelines.
Overall, while the bill could significantly positively impact individuals’ access to contraceptives by removing barriers and simplifying the acquisition process, there are several technical and practical concerns that need addressing to ensure smooth implementation and to maximize the bill's intended benefits.
Issues
The definition of 'the Secretary' is unclear. It appears multiple Secretaries are involved (e.g., Health and Human Services, Labor, Treasury), but this is not specified initially, potentially causing confusion. This relates to Section 2, subsections (a) and (b).
The text contains vague language regarding 'the total day supply (not to exceed a 365-day supply).' It does not explicitly define whether individuals can choose any amount up to 365 days, which might lead to varying interpretations by insurers and enrollees. This is an issue in Section 2, subsection (a)(1).
Section 2, subsection (b) mandates outreach activities without defining what 'such outreach activities as are necessary' means, which could result in inconsistent implementation by the involved Secretaries.
There is no mention of the budget or resources allocated for conducting the outreach activities specified in Section 2, subsection (b), which could lead to unexpected financial implications and impact the execution of the outreach.
The amendment references compliance and amendments to existing laws, but does not fully explain potential impacts on current regulations or any possible unintended consequences, as noted in Section 2.
Sections
Sections are presented as they are annotated in the original legislative text. Any missing headers, numbers, or non-consecutive order is due to the original text.
1. Short title Read Opens in new tab
Summary AI
The first section of the bill simply states that the official name of the act is the "Convenient Contraception Act."
2. Requiring group health plans and group and individual health insurance coverage to permit an individual to obtain a 365-day supply of contraceptives Read Opens in new tab
Summary AI
The section requires health insurance plans to allow individuals to obtain up to a 365-day supply of contraceptives at once without additional cost, starting from 2026. Additionally, within 90 days of the law's enactment, government officials must inform healthcare providers and those enrolled in or eligible for these insurance plans about the new rule.