The Department of Labor is gathering comments on the potential benefits and costs of employer health plans covering over-the-counter (OTC) preventive items and services without cost sharing and without a prescription.
Significant employer costs? Covering all out-of-pocket nondurable medical products could cost employers up to $95.1 billion per year.
Most plans don’t cover preventive products without a prescription. DOL believes expanding utilization of preventive care and services would minimize cost barriers for plan participants.
Important for contraceptive care? The Biden administration believes this is an important option to consider for expanding access to contraceptive care.
Public comment requested. The RFI asks for comments on implementation issues, impact on health equity, and economic costs. Comments are due December 4, 2023.
Court challenge pending. On March 30, 2023, a federal court struck down the ACA mandate that requires employer health plans to cover without cost sharing the preventive service recommendations of the U.S. Preventive Services Task Force that have an “A” or “B” rating. The lower court decision has been stayed pending appeal.