Smartphone App Could Add $3B To Obamacare Costs

Headline Health – With 75 million American women of childbearing age, and Obamacare mandates to fund every conceivable mode of “health care,” the medical establishment has an enormous incentive to invent new, “must-have” services, treatments, drugs, and devices.

We’re learning that the FDA has cleared a new $79-per-year smartphone app women can use to track their ovulation.

If just 50 percent of women of childbearing age requested (or were ordered to use) this app, the financial burden on the nation could amount to $2.96 billion. More from STAT …

Inside STAT: Will insurers have to cover a pregnancy prevention app?

Now that the FDA has cleared the controversial Natural Cycles app as a pregnancy prevention tool, questions have cropped up about whether insurers will have to cover the app under Obamacare’s contraception mandate. Experts say that means the $9.99-a-month app, which uses basal temperature to predict ovulation, should be covered.

But it’s anyone’s guess how that will actually work. “What’s the official trigger that tells insurance companies they have to cover it now?” said the Guttmacher Institute’s Adam Sonfield. The answer to that still isn’t clear. STAT’s Kate Sheridan has the story …

Will insurers have to cover the controversial contraception app Natural Cycles under Obamacare’s mandate?

Kate Sheridan, STAT – The Affordable Care Act’s embattled requirement to cover contraceptives ought to include the smartphone app that’s FDA-cleared to prevent pregnancy, according to experts. But it’s anyone’s guess how that might work.

The company that makes the app, also called Natural Cycles, clearly thinks insurers might be willing. Its product costs $79 per year or $9.99 per month. Soon, someone will fill an open position at the company and begin liaising with U.S. insurers — including, potentially, Medicaid.

That person will be stepping onto fraught legislative terrain. Under the Affordable Care Act, insurers should cover all FDA-approved contraceptive methods, and the person they are insuring should have no out-of-pocket costs.

But that mandate has been repeatedly challenged in the courts and undermined by the executive branch.

Currently, the Health Resources and Services Administration’s Women’s Preventive Services Guidelines include “the full range of contraceptive methods for women,” including the birth control pill, IUDs, and sterilization procedures, as well as “additional methods as identified by the FDA.”

“These seem like ‘additional methods identified by the FDA.’ The question is, as identified where and how — what actually triggers the change?” said Adam Sonfield, a senior policy manager at the Guttmacher Institute. “What’s the official trigger that tells insurance companies they have to cover it now?”

And once that trigger gets pulled, it’s also not clear how long insurers will have to comply.

In theory, Sonfield said, it could take as long as a year and a half — that’s how long it would take if the FDA clearance triggered a new requirement for coverage.

Plans would get one year from the decision date, plus the time between that one-year time frame and the start of the next year of coverage — which generally happens in December or January. Read more. 

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