Text of Agency Final Regs: Religious Exemptions and Accommodations for Coverage of Certain Preventive Services Under the ACA

202 pages. "These rules finalize, with changes based on public comments, interim final rules concerning religious exemptions and accommodations regarding coverage of certain preventive services ... These rules expand exemptions to protect religious beliefs for certain entities and individuals whose health plans are subject to a mandate of contraceptive coverage through guidance issued pursuant to the [ACA]. These rules do not alter the discretion of the Health Resources and Services Administration ... to maintain the guidelines requiring contraceptive coverage where no regulatorily recognized objection exists. These rules also leave in place an 'accommodation' process as an optional process for certain exempt entities that wish to use it voluntarily. These rules do not alter multiple other federal programs that provide free or subsidized contraceptives for women at risk of unintended pregnancy." Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; Internal Revenue Service [IRS]; and U.S. Department of Health and Human Services [HHS]

Text of Agency Final Regs: Moral Exemptions and Accommodations for Coverage of Certain Preventive Services Under the ACA

147 pages. "These rules finalize, with changes based on public comments, the interim final rules issued in the Federal Register on October 13, 2017 concerning moral exemptions and accommodations regarding coverage of certain preventive services. These rules finalize expanded exemptions to protect moral beliefs for certain entities and individuals whose health plans are subject to a mandate of contraceptive coverage through guidance issued pursuant to the [ACA]. These rules do not alter the discretion of the Health Resources and Services Administration ... to maintain the guidelines requiring contraceptive coverage where no regulatorily recognized objection exists. These rules also leave in place an optional 'accommodation' process for certain exempt entities that wish to use it voluntarily. These rules do not alter multiple other federal programs that provide free or subsidized contraceptives for women at risk of unintended pregnancy." Employee Benefits Security Administration [EBSA], U.S. Department of Labor [DOL]; Internal Revenue Service [IRS]; and U.S. Department of Health and Human Services [HHS]

Text of CMS Proposed Regs: ACA Exchange Program Integrity

63 pages. "This proposed rule would revise standards relating to oversight of Exchanges established by states, periodic data matching frequency and authority, and the length of a consumer's authorization for the Exchange to obtain updated tax information. This proposed rule would also propose new requirements for certain issuers related to the collection of a separate payment for the premium portion attributable to coverage for certain abortion services. Many of these proposed changes would help strengthen Exchange program integrity." Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Fact Sheet: Final Rules on Religious and Moral Exemptions and Accommodation for Coverage of Certain Preventive Services Under the ACA

" Exemptions for Religious Beliefs: The first of two final rules provides an exemption from the contraceptive coverage mandate to entities and individuals that object to services covered by the mandate on the basis of sincerely held religious beliefs. Thus, entities that have sincerely held religious beliefs against providing contraceptive services (or services which they consider to be abortifacients) would be exempt from the mandate and no longer be required to provide such coverage. The rules maintain the availability of the accommodation, in which the entity's insurer or third party administrator is responsible for providing contraceptive services to the entity's plan participants and beneficiaries, but they make it voluntary, at the option of the entity. That is, an otherwise exempt entity can elect to take advantage of the accommodation, which would provide contraceptive coverage to its employees and their dependents. Entities that object to covering some, but not all, contraceptive items would be exempt with respect to only those methods to which they object. The exemption is also applicable to institutions of higher education, insurance issuers to the extent they provide a plan to otherwise exempt entities, and individuals whose employers and issuers are willing to provide them a plan compliant with the individuals' beliefs....

Exemptions for Moral Convictions: This rule gives nonprofit organizations, small businesses, and individuals that have non-religious moral convictions opposing services covered by the contraceptive mandate protections that are similar to the religious final rule's protections for religious organizations and businesses. The exemptions apply to nonprofit organizations and to closely held businesses, as well as to institutions of education, health insurance issuers serving exempt entities, and individuals. The voluntary accommodation is also available to entities with moral convictions against providing contraceptive services (or services which they consider to be abortifacient) in their health plans."
U.S. Department of Health and Human Services [HHS]

Fact Sheet for Exchange Program Integrity Proposed Rule (PDF)

"[K]ey proposals in this rule would amend standards relating to oversight of [State-based Exchanges (SBEs)], periodic data matching frequency and data disclosure authority. This proposed rule would also reinforce the PPACA requirements related to the collection of separate payments for certain abortion services related to these services which serve the dual purpose of helping issuers meet the statutory requirement to keep funds for these services separate from federal funds and helping consumers understand that they have selected a plan that includes this coverage. These proposed changes will help strengthen Exchange program integrity, including helping stabilize Exchange premiums." Centers for Medicare & Medicaid Services [CMS], U.S. Department of Health and Human Services [HHS]

Trump Administration Issues Final Rules Protecting Conscience Rights in Health Insurance

"The first of today's final rules provides an exemption from the contraceptive coverage mandate to entities that object to services covered by the mandate on the basis of sincerely held religious beliefs. The second final rule provides protections to nonprofit organizations and small businesses that have non-religious moral convictions opposing services covered by the mandate. The religious and moral exemptions provided by these rules also apply to institutions of education, issuers, and individuals. The Departments are not extending the moral exemption to publicly traded businesses, or either exemption to government entities.... The rules leave in place government programs that provide free or subsidized contraceptive coverage to low income women, such as through community health centers. These regulations do not ban any drugs or devices or prohibit any employer from covering contraceptives. The Departments estimate the exemptions should affect no more than approximately 200 employers with religious or moral objections. The rules take effect 60 days after their publication in the Federal Register." U.S. Department of Health and Human Services [HHS]