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	<title>Comments on: Implementing Health Reform: Contraceptive Coverage And Religious Accommodation</title>
	<atom:link href="http://healthaffairs.org/blog/2013/02/02/implementing-health-reform-contraceptive-coverage-and-religious-accommodation/feed/?author=2338" rel="self" type="application/rss+xml" />
	<link>http://healthaffairs.org/blog/2013/02/02/implementing-health-reform-contraceptive-coverage-and-religious-accommodation/?utm_source=rss&#038;utm_medium=rss&#038;utm_campaign=implementing-health-reform-contraceptive-coverage-and-religious-accommodation</link>
	<description>The Policy Journal of the Health Sphere</description>
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		<title>By: John Fembup</title>
		<link>http://healthaffairs.org/blog/2013/02/02/implementing-health-reform-contraceptive-coverage-and-religious-accommodation/comment-page-1/#comment-261634</link>
		<dc:creator>John Fembup</dc:creator>
		<pubDate>Wed, 06 Feb 2013 22:48:58 +0000</pubDate>
		<guid isPermaLink="false">http://healthaffairs.org/blog/?p=27821#comment-261634</guid>
		<description><![CDATA[&quot;. . . the basic idea is that the TPA would take responsibility for providing coverage, and in turn contract with an insurer in the individual market to provide the coverage. &quot;

It remains to be seen whether this basic idea will persuade the courts to dismiss the objections that have been raised to all this.  It also remains to be seen whether the idea is practical; it seems to me complex and anything but straightforward.  

Will objections mostly come from insurance companies?  Maybe, but I think they will also arise from TPA&#039;s including insurance companies acting solely as TPA&#039;s for their self-insured customers.    For one thing, TPA&#039;s won&#039;t want to accept liability for placing any insurance.  That will impose on them not simply new administrative costs, but potentially new insurance costs, which may also need to include protection from liability for being sued by insured persons just like with any other insurance.  It also remains to be seen how large the insurance premiums for contraceptive coverage will be.  The unit cost is low but as the units are &quot;free&quot; to insured persons there is no restraint to utilization  - so the premiums may well be consequential.  [For such low-cost units, it still seems to me more efficient and not at all obstructive, simply to continue with direct purchase or with the freebies presently handed out by organizations such as Planned Parenthood - and avoid the entire Rube-Goldberg contraption of &quot;insurance&quot; dreamed up by HHS in this case].  Also - do FFE&#039;s already exist or would their presence mean another bureaucracy must be created? 

A lot, it seems to me, remains to be seen.]]></description>
		<content:encoded><![CDATA[<p>&#8220;. . . the basic idea is that the TPA would take responsibility for providing coverage, and in turn contract with an insurer in the individual market to provide the coverage. &#8221;</p>
<p>It remains to be seen whether this basic idea will persuade the courts to dismiss the objections that have been raised to all this.  It also remains to be seen whether the idea is practical; it seems to me complex and anything but straightforward.  </p>
<p>Will objections mostly come from insurance companies?  Maybe, but I think they will also arise from TPA&#8217;s including insurance companies acting solely as TPA&#8217;s for their self-insured customers.    For one thing, TPA&#8217;s won&#8217;t want to accept liability for placing any insurance.  That will impose on them not simply new administrative costs, but potentially new insurance costs, which may also need to include protection from liability for being sued by insured persons just like with any other insurance.  It also remains to be seen how large the insurance premiums for contraceptive coverage will be.  The unit cost is low but as the units are &#8220;free&#8221; to insured persons there is no restraint to utilization  &#8211; so the premiums may well be consequential.  [For such low-cost units, it still seems to me more efficient and not at all obstructive, simply to continue with direct purchase or with the freebies presently handed out by organizations such as Planned Parenthood - and avoid the entire Rube-Goldberg contraption of "insurance" dreamed up by HHS in this case].  Also &#8211; do FFE&#8217;s already exist or would their presence mean another bureaucracy must be created? </p>
<p>A lot, it seems to me, remains to be seen.</p>
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		<title>By: Ellen R. Shaffer</title>
		<link>http://healthaffairs.org/blog/2013/02/02/implementing-health-reform-contraceptive-coverage-and-religious-accommodation/comment-page-1/#comment-260401</link>
		<dc:creator>Ellen R. Shaffer</dc:creator>
		<pubDate>Sat, 02 Feb 2013 15:12:12 +0000</pubDate>
		<guid isPermaLink="false">http://healthaffairs.org/blog/?p=27821#comment-260401</guid>
		<description><![CDATA[No doubt the Dred Scott decision would have elicited over 200,000 comments, including many from supportive slave owners, in its time.  The fact is, contraception is not controversial among 99% of the public, including the vast majority who voted in November to oppose this mythical assertion, which nevertheless has very real, concrete and deleterious consequences, particularly for low-income women. (see Shaffer, Sarfaty and Ash in Medical Care on this point.)  This decision, from an Administration that promised barely a week ago to honor the legacies of Seneca Falls, Selma, and Stonewall, is a rude awakening.]]></description>
		<content:encoded><![CDATA[<p>No doubt the Dred Scott decision would have elicited over 200,000 comments, including many from supportive slave owners, in its time.  The fact is, contraception is not controversial among 99% of the public, including the vast majority who voted in November to oppose this mythical assertion, which nevertheless has very real, concrete and deleterious consequences, particularly for low-income women. (see Shaffer, Sarfaty and Ash in Medical Care on this point.)  This decision, from an Administration that promised barely a week ago to honor the legacies of Seneca Falls, Selma, and Stonewall, is a rude awakening.</p>
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