A number of maternal and child health (MCH)-related issues have been generating headlines recently, and Network attorneys have been called on to provide legal expertise and information about these issues. For example, we received several questions regarding provisions of the Affordable Care Act (ACA) that require many health insurance plans to provide coverage for women’s preventive health services at no cost to the insured. We were able to provide the requesters with a list of the covered services (including well-woman preventive care visits, FDA-approved contraceptives, and counseling on sexually transmitted infections, among others), explain which plans are subject to the requirements (most individual and group plans) and explain what “grandfathering” means (it doesn’t involve your parents’ dads).
The Network also received several questions about recent court decisions and administrative pronouncements regarding availability of emergency contraception that is very effective in preventing pregnancy if taken within a few days of unprotected sex. Briefly, in 2006 the FDA approved a two-pill form of emergency contraception marketed as “Plan B” to be available over the counter for purchasers over the age of 18 and who can provide government issued identification. In 2009, federal district court Judge Edward R. Korman ordered that the FDA make the drug available to 17 year olds without a prescription, and reconsider all age and other restrictions on over-the-counter access in light of existing evidence.
In 2011, the FDA recommended, after an extensive scientific inquiry and on the advice of organizations such as the American Medical Association and the American Academy of Pediatrics, that the drug be made available over-the-counter to all women. However, in an unprecedented move, this decision was overruled by the Department of Health and Human Services.
In April of this year, Judge Korman ordered that both Plan B and a one-pill version, Plan B One-Step, be made available to all women over the counter without age restrictions unless the FDA could identify a “significant difference” between the two pills. The Obama Administration appealed Judge Korman’s decision on May 1, 2013, just one day after the FDA approved an application for Plan B One-Step to be sold over the counter only to individuals ages 15 and over (which did not satisfy Judge Korman’s order). Just this week, the Administration announced that it would drop the pending appeal and make Plan B One-Step available to women of all ages without a prescription as soon as it receives the appropriate paperwork, which is where things currently stand.
There is certainly more to come in both of these evolving areas of law. For much more on these and other MCH-related questions, visit the MCH section on the Network website and legal assistance library. As always, please contact the Network with any questions you might have about these or any other public health-law related issues.
This blog post was prepared by Corey Davis, J.D., M.S.P.H., staff attorney with the Network for Public Health Law – Southeastern Region at the National Health Law Program (NHeLP) and Erin Armstrong, J.D., staff attorney at the National Health Law Program (NHeLP).
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state. The views expressed in this post do not represent those of the Robert Wood Johnson Foundation.