MONEY Health Care

How Some Insurers Still Avoid Covering Contraception

Locked up birth control pills
Nicholas Eveleigh—Getty Images

Under health reform, your birth control should be fully paid for by insurance. But even before the Supreme Court gave more employers an out, some insurers have been pushing back.

How much leeway do employers and insurers have in deciding whether they’ll cover contraceptives without charge and in determining which methods make the cut?

Not much, as it turns out, but that hasn’t stopped some from trying.

Kaiser Health News readers still write in regularly describing battles they’re waging to get the birth control coverage they’re entitled to.

In one of those messages recently, a woman said her insurer denied free coverage for the NuvaRing. This small plastic device, which is inserted into the vagina, works for three weeks at a time by releasing hormones similar to those used by birth control pills. She said her insurer told her she would be responsible for her contraceptive expenses unless she chooses an oral generic birth control pill. The NuvaRing costs between $15 and $80 a month, according to Planned Parenthood.

Under the health law, health plans have to cover the full range of FDA-approved birth control methods without any cost sharing by women, unless the plan falls into a limited number of categories that are excluded, either because it’s grandfathered under the law or it’s for is a religious employer or house of worship. Following the recent Supreme Court decision in the Hobby Lobby case, some private employers that have religious objections to providing birth control coverage as a free preventive benefit will also be excused from the requirement.

In addition, the federal government has given plans some flexibility by allowing them to use “reasonable medical management techniques” to keep their costs under control. So if there is both a generic and a brand-name version of a birth-control pill available, for example, a plan could decide to cover only the generic version without cost to the patient.

As for the NuvaRing, even though they may use the same hormones, the pill and the ring are different methods of birth control. As an official from the federal Department of Health and Human Services said in an email, “The pill, the ring and the patch are different types of hormonal methods … It is not permissible to cover only the pill, but not the ring or the patch.”

Guidance from the federal government clearly states that the full range of FDA-approved methods of birth control must be covered as a preventive benefit without cost sharing. That includes birth control pills, the ring or patch, intrauterine devices and sterilization, among others.

But despite federal guidance, “we’ve seen this happen, plenty,” says Adam Sonfield, a senior public policy associate at the Guttmacher Institute, a reproductive health research and education organization. “Clearly insurance companies think things are ambiguous enough that they can get away with it.”

If you are denied coverage, your defense is to appeal the decision, and get your state insurance department involved.

“The state has the right and responsibility to enforce this law,” says Sonfield.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

More on the Affordable Care Act and contraception coverage:

 

 

 

 

 

TIME Supreme Court

Supreme Court Puts Hold on Virginia Same-Sex Marriages

Supreme Court Blocks Virginia Gay Marriages
A guard stands on the steps of the Supreme Court Building, August 20, 2014 in Washington, D.C. Mark Wilson—Getty Images

Same-sex marriages could have begun as early as Thursday

The Supreme Court effectively barred same-sex couples from marrying in Virginia Wednesday after it delayed a lower court decision that would have lifted the state’s gay marriage ban. The appeals court ruling demanded that Virginia recognize out of state same-sex marriages and would have allowed same sex-couples to marry as early as Thursday morning.

Same-sex couples in Virginia must now wait until the Supreme Court decides to either decline to hear the appeal, under which the stay would be waived, or to reach a verdict of its own.

The Supreme Court did not provide an explanation for the order, which was requested by a Virginia court clerk, but it didn’t come as a surprise after it put same sex-unions on hold in Utah earlier this year.

The top plaintiff in the case, Tim Bostic, told USA Today that he preferred to hear a verdict from the Supreme Court.

“While we are disappointed that marriages will have to wait, this was not unexpected,” he said. “We feel that this case deserves to be heard by the Supreme Court and be finally decided for all Americans.”

Virginia voted in 2006 to ban gay marriage, but both of Virginia’s Democratic senators—Tim Kaine and Mark Warner—endorsed the practice last year.

 

TIME Supreme Court

High Court Blocks Same-Sex Unions in Virginia

(RICHMOND, Va.) — Same-sex couples will have to wait longer to begin marrying in Virginia after the U.S. Supreme Court agreed Wednesday to delay an appeals court ruling striking down the state’s gay marriage ban.

The nation’s highest court granted a request from a county clerk in northern Virginia to delay a decision by the 4th U.S. Circuit Court of Appeals in Richmond that would have allowed for same-sex couples to marry beginning Thursday morning. The state would have also had to start recognizing gay marriages from out of state if the Supreme Court had denied the request. The court provided no explanation for its order.

The federal appeals court last week refused to delay its decision striking down the ban, issued in late July, while it is appealed to the high court. The appeals court’s order did not explain why it denied that request.

The Supreme Court’s decision was not unexpected, as it previously issued an order in January putting same-sex unions on hold in Utah while the federal appeals court in Denver was hearing the case. That court upheld the decision striking down Utah’s gay marriage ban, but delayed its decision from taking effect pending appeal to the Supreme Court. Most other federal court decisions in favor of same-sex marriage also have been put on hold.

Virginia voters approved a constitutional amendment in 2006 that banned gay marriage and prohibited the recognition of such marriages performed in other states.

The appeals court ruling overturning that ban was the third such ruling by a federal appeals court and the first in the South, a region where the rising tide of rulings favoring marriage equality is testing concepts of states’ rights and traditional, conservative moral values that have long held sway.

Virginia Attorney General Mark Herring — who has said he will not defend the state’s ban and believes the courts ruled correctly in striking it down — asked the Supreme Court earlier this month to review a lower court’s decision striking down the state’s ban. Herring said he believes the case will prove compelling to the high court because of the “stringent, discriminatory nature of Virginia’s marriage ban” and other factors.

The Virginia lawsuit was filed by Timothy Bostic and Tony London of Norfolk, who were denied a marriage license, and Carol Schall and Mary Townley of Chesterfield County. The women were married in California and wanted their marriage recognized in the state where they are raising a 16-year-old daughter.

A panel of the 6th U.S. Circuit Court of Appeals in Cincinnati recently considered arguments regarding six cases from Michigan, Ohio, Kentucky and Tennessee. Some observers have said the 6th Circuit may be the first to uphold statewide gay marriage bans after more than 20 consecutive rulings in the past eight months striking them down.

TIME 2014 Election

President Obama Suggests Upcoming Supreme Court Vacancy

The President suggests for the first time a Supreme Court vacancy in his final two years of office

President Barack Obama hinted at the possibility of an upcoming vacancy on the Supreme Court Monday during a fundraiser for Senate Democrats.

Speaking to a group of donors to the Democratic Senatorial Campaign Committee on a break from his vacation in Martha’s Vineyard, Obama said he needs Democrats to hold a majority this year to fill vacancies to the high court.

“What’s preventing us from getting things done right now is you’ve got a faction within the Republican Party that thinks solely in terms of their own ideological purposes and solely in terms of how do they hang on to power,” Obama said. “And that’s a problem. And that’s why I need a Democratic Senate. Not to mention the fact that we’re going to have Supreme Court appointments, and there are going to be a whole host of issues that many people here care about that are going to be determined by whether or not Democrats retain the Senate.”

It was not the first time Obama has tied the Supreme Court to the midterm elections, but it was the first time Obama has explicitly suggested there would be a vacancy in his final years. Two of the Court’s left-leaning justices, Ruth Bader Ginsburg and Stephen Breyer, 81 and 75 respectively, have been facing calls from Democrats to step aside before Obama leaves office in 2017 to ensure that their seats remain occupied by liberals in the event Republicans regain the White House.

Ginsburg brushed aside calls for her retirement last month in an interview with Yahoo News’ Katie Couric. “All I can say is that I am still here and likely to remain for a while,” she said. Ginsburg has twice been treated for cancer while on the bench.

Obama successfully nominated Justices Elena Kagan and Sonia Sotomayor to the Supreme Court in his first two years in office. If Democrats lose the Senate this November, Obama would find it nearly impossible to get a Supreme Court nominee with a liberal bent confirmed.

A White House spokesperson said Obama did not have a specific vacancy in mind Monday. “The President’s comments were meant to convey the important role the Senate would play in the event of a Supreme Court vacancy,” the spokesperson said. “They were not in reference to a specific vacancy.”

TIME technology

Missouri Passes Constitutional Amendment to Protect Electronic Privacy

Some Missouri lawmakers hopes other states follow its lead on protecting privacy.

Missouri became the first state in the nation Tuesday to offer explicit constitutional protections of electronic communications and data from warrantless search and seizure by law enforcement.

The amendment to the state’s constitution places communications such as emails, text messages, and cloud storage under the same Fourth Amendment protection from unreasonable searches and seizures as “persons, homes, papers and effect” and will require police to have a warrant to gain access to phones, laptops, and electronic communications. It passed with 75% support in a statewide ballot effort.

“Yesterday’s overwhelming support for Amendment 9 reflects the emotion that Missourians feel about the invasion of their privacy,” said Republican state Sen. Rob Schaaf, who co-sponsored the measure with Republican Sen. Bob Dixon . “People are upset and they spoke with a very loud voice. They don’t want the government snooping.”

Schaaf says that the amendment’s specific legal impact will “take time to sort out” in Missouri, but he believes that the court will interpret it along the same lines as it interprets the right to privacy in person, paper, home, and effects. However, he believes that the national attention that the amendment receives will be its biggest impact, as that may inspire other states to follow suit.

“I think other states will look at this vote and they will follow Missouri’s lead,” Schaaf says.

The U.S. Supreme Court ruled in June that law enforcement must obtain a warrant to search cell phones seized during arrest, but the ruling did not address broader concerns about data privacy on other devices. The Missouri amendment will include laptops and communications alongside the Supreme Court’s cell phone ruling.

Federal legislation has been proposed to address the need for updated electronic communication privacy protections stored by third parties. The Email Privacy Act would update to the Electronic Communications Act of 1986, which Chris Calabrese, American Civil Liberties Union’s legislative counsel for privacy, pointed out has not been updated “substantially” since the new era of personal electronics took hold. The legislation has been passed by the Senate Judiciary Committee, but is currently in the House. “I think states will continue to act independently if there’s no federal legislation,” Calabrese says. “People care about privacy.”

TIME politics

Ruth Bader Ginsburg: Male Justices Have ‘Blind Spot’ About Women

Supreme Court Justice Ruth Bader Ginsburg at the taping of "The Kalb Report" at the National Press Club in Washington, DC. on April 17, 2014.
Supreme Court Justice Ruth Bader Ginsburg at the taping of "The Kalb Report" at the National Press Club in Washington, DC. on April 17, 2014. Alex Wong—Getty Images

Notorious R.B.G strikes again

In the wake of the Supreme Court Hobby Lobby ruling, which allows religious employers to deny birth control coverage to female employees, Ruth Bader Ginsburg said the male justices in the majority have a “blind spot” about women’s issues.

“Do you believe that the five male justices truly understood the ramifications of their decision?” Katie Couric asked Ginsburg in a Yahoo interview.

“I would have to say no,” Ginsburg replied.

“But justices continue to think and change. They have wives. They have daughters,” she continued. “By the way, I think daughters can change the perception of their fathers. I am ever hopeful that if the court has a blind spot today, its eyes will be open tomorrow.”

But will Ginsburg still be on the court tomorrow? Some liberals are urging Ginsburg, 81, to retire so President Obama can fill her seat with another Democrat.

“All I can say is that I am still here and likely to remain for a while,” she said.

So it looks like Notorious R.B.G is here to stay, and now she finally knows about her nickname. Couric asked her about the Tumblr a female fan created that compares Ginsburg to the rapper Notorious B.I.G.

“She has created a wonderful thing with Notorious R.B.G.,” Ginsburg said. “I will admit I had to be told by my law clerks, what’s this Notorious. And they — they explained that to me.”

TIME wedding

Ruth Bader Ginsburg Responds Perfectly to Fan’s Wedding Invite

Supreme Court Justice Ruth Bader Ginsburg makes remarks during a forum at the Newseum to mark the 30th anniversary of the first female Justice Sandra Day O'Connor's first term on the Supreme Court in Washington, DC, April 11, 2012.
Supreme Court Justice Ruth Bader Ginsburg makes remarks during a forum at the Newseum to mark the 30th anniversary of the first female Justice Sandra Day O'Connor's first term on the Supreme Court in Washington, DC, April 11, 2012. Mike Theiler—REUTERS

The Notorious R.B.G. knows how to RSVP

Inviting celebrities to your wedding is nothing new—Peyton Manning and the Obamas seem to be popular choices. But Staci Zaretsky, editor at Above the Law, took it to the next level by asking if Supreme Court Justice Ruth Bader Ginsburg would attend her nuptials.

Justice Ginsburg—or as Zaretsky and her fiancé affectionately call her, “The Notorious R.B.G.”— has long been an idol of Zaretsky.

“My fiancé and I decided to invite everyone who had ever made an impact on our lives, big or small,” Zaretsky wrote in an article for Above the Law. “To stay true to the way we invited all of our guests, I wanted to invite the justice who made the biggest impact on my life.”

But when she sent a handwritten letter and wedding invitation to Ginsburg, she didn’t anticipate a response, let alone a personal note.

This is the letter Staci Zaretsky received from Justice Ruth Bader Ginsburg responding to Zaretsky's wedding invitation.
This is the letter Staci Zaretsky received from Justice Ruth Bader Ginsburg responding to Zaretsky’s wedding invitation. Staci Zaretsky—Above the Law

Ginsburg has surely made an impact on the lives of many as an advocate for women across the country. In the June 30 5-4 ruling of the Supreme Court Hobby Lobby case, she made her feelings clear:

“Approving some religious claims while deeming others unworthy of accommodation could be ‘perceived as favoring one religion over another,’ the very ‘risk the [Constitution's] Establishment Clause was designed to preclude” wrote the the Justice.

Regardless of your stance on the Hobby Lobby decision, there’s no arguing that Ginsburg is a powerful woman, and now, a most gracious wedding guest.

 

TIME Crime

Arizona Execution Will Move Forward After Last-Minute Appeals

Lethal Injection Execution
Walls Unit in Huntsville prison where lethal injections are carried out on inmates in Huntsville, Texas. Jerry Cabluck—Sygma/Corbis

The court, reluctant to step into the battle over lethal injection, denies a constitutional challenge by Arizona death row inmate Joseph Wood over the secrecy of execution drugs

Updated at 3 p.m. E.T. Wednesday

A rare victory for a death row inmate over the weekend was quashed Tuesday when the Supreme Court lifted a stay of execution for Joseph Wood, who was sentenced to death for the murder of his girlfriend and her father in 1989.

In a three-sentence order, the Supreme Court reversed a judgment by the U.S. Ninth Circuit Court of Appeals that halted Wood’s execution based on the secrecy surrounding where the state obtains the drugs to carry out lethal injection. About a half-hour after Wood was scheduled to be executed, Arizona’s top court announced that it had temporarily halted the execution on appeals. Wood’s lawyers said he did not have proper legal representation. They also claimed that Arizona’s “experimental” lethal injection methods, which include drugs like midazolam that have been used in executions that have gone awry in other states, would violate the Eighth Amendment’s ban on cruel and unusual punishment. But that stay was lifted Wednesday afternoon after the court heard last-minute appeals from Wood’s lawyers, clearing the way for Wood to be executed by lethal injection.

Death row inmates around the U.S. have challenged the constitutionality of their lethal injections, often arguing that the laws and policies shielding drug manufacturers’ identities are unconstitutional. Due to drug shortages and boycotts by pharmaceutical companies, many states in the last few years have obtained lethal injection drugs from compounding pharmacies, which are unregulated by the federal government.

Courts around the country have been largely unreceptive to those arguments. Wood’s case, however, was an exception.

Wood’s lawyers asked the state to halt his execution if it did not provide the origins of the drugs as well as the qualifications of the executioners, relying not on an Eighth Amendment argument regarding the risk of cruel and unusual punishment, but rather a First Amendment defense that Wood had a right to access information about his execution. A U.S. District Court judge in Phoenix initially denied the request, but the Ninth Circuit sided with Wood.

The court denied appeals by the state to lift the stay, sending the case to the Supreme Court, which has been reluctant to step into the ongoing battle over lethal injection.

But while the fate of lethal injection in the U.S. remains uncertain, reverting to an older method of executions got an unexpected endorsement. In a separate opinion by the Ninth Circuit that upheld Wood’s stay of execution before the Supreme Court intervened, Judge Alex Kozinski called lethal injection flawed and proposed bringing back the firing squad.

“If some states and the federal government wish to continue carrying out the death penalty, they must turn away from this misguided path and return to more primitive—and foolproof—methods of execution,” Judge Kozinski wrote. “The guillotine is probably best but seems inconsistent with our national ethos. And the electric chair, hanging and the gas chamber are each subject to occasional mishaps. The firing squad strikes me as the most promising. Eight or ten large-caliber bullets fired at close range can inflict massive damage, causing instant death every time. … Sure, firing squads can be messy, but if we are willing to carry out executions, we should not shield ourselves from the reality that we are shedding human blood.”

Legislators in several states have proposed bringing back firing squads. Only Oklahoma and Utah currently allow them, according to the Death Penalty Information Center, but only under very limited circumstances.

Wood’s execution was set for Wednesday morning.

TIME

New Clinton Docs Disparage Ginsburg, Underscore Security Concerns at Atlanta Olympics

Clinton Global Initiative America Meetings Begin In Chicago
Former President Bill Clinton listens as Chicago Mayor Rahm Emanuel speaks to guests at the Clinton Global Initiative (CGI) on June 13, 2013 in Chicago, Illinois. Scott Olson—Getty Images

Among other revelations in the newly-released papers, the White House warned of the Supreme Court candidate's "halting speech" and "laconic nature" in one memo

The latest trove of previously-unreleased documents from the Clinton White House reveal the administration’s candid and at times unflattering assessment of Ruth Bader Ginsburg before her confirmation to the Supreme Court.

The memo, drafted by then-White House Associate Counsel Ron Klain to David Gergen, lists Ginsburg’s defense of the American Civil Liberties Union and “her failure to make eye contact, her halting speech, her “laconic” nature” as potential “performance pitfalls” for her in Senate confirmation hearings. It also includes the underlined warning that, “Judge Ginsburg views the White House’s interest and her interests as being at odds with each other.”

“She sees us as having a stake in presenting her as a moderate and in getting along well with the Senate; she sees her interests as ‘being herself,’ preserving her ‘dignity,’ and promoting her ‘independence,'” the memo continued.

The document is part of the latest batch of memos from the Clinton administration that have been released by the Clinton Library over the past several months. Also in this release is a memo from Klain outlining the subjects President Bill Clinton should bring up and which to avoid in a conversation with soon-to-be Supreme Court Justice Stephen Breyer.

Also of note is the multiple-choice memo to Clinton seeking his preferences for a planned trip to Spain, Poland, Romania and Denmark, and a White House memo outlining contingency planning for the 1996 Atlanta Olympic Games.

Bonus: With this check mark, President Bill Clinton began the process of nominating Sonia Sotomayor to the Second Circuit Court of Appeals.

Clinton Library

The Ginsburg memo:

The Breyer memo:

The Olympics memo:

The trip planning memo:

TIME Religion

Atheist to Give First Town Board Invocation Following Supreme Court Battle

A Supreme Court decision upholding prayer before town board meetings has emboldened non-believers to give their own messages

As the Supreme Court heard oral arguments last November on whether town board meetings that open with prayer violate the First Amendment, Justice Antonin Scalia asked a rhetorical question: What does an invocation sound like from a non-believer?

Dan Courtney has an answer. The former president of the Freethinkers of Upstate New York will deliver the invocation before the town board of Greece, New York Tuesday evening, the same town at the center of the recent Supreme Court case.

Courtney says he contacted the board the same day the court ruled 5-4 that prayer did not violate the First Amendment’s Establishment Clause prohibiting the government from establishing an official religion. And he’ll soon be one of several non-believers around the U.S. who have recently delivered secular messages before public town meetings.

While Courtney says he wasn’t surprised by the ruling, he was disappointed.

“Sectarian prayer is very divisive,” he says. “Almost by definition, you’re excluding a portion of people who don’t believe in that doctrine, and it excludes the 20% of the population that is non-religious.”

But at the same time, the Supreme Court ruling appears to have emboldened several non-believers to deliver their own messages in a public forum, including an invocation at the Osceola County, Fla., board of commissioners meeting by a member of the Central Florida Freethought Community and several invocations by a non-believer at Portage, Michigan city council meetings.

In his message, Courtney says he’ll draw on the Declaration of Independence and invoke the idea that governments derive their authority from the people, not a higher power.

“If you’re an American, this should resonate with you,” he says.

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