The ACA was designed to ensure benefits for underserved groups, including women. Thanks to mandatory essential care stipulations, many healthcare services for women are now covered by insurance, including well woman visits and FDA approved contraception.
In addition, permanent forms of birth control, such as tubal ligation, are now included under essential coverage requirements. Although women now enjoy coverage for permanent forms of birth control, Obamacare does not stipulate coverage for vasectomy as essential. This doesn’t necessarily mean that insurance won’t cover the procedure, but insurance providers are not required by law to include this coverage.
The next question many people have is whether or not Obamacare covers reversal of permanent contraception. In the case of tubal ligation, the answer is no. The law does not mandate coverage for reversal of tubal ligation, although neither does it prohibit this coverage.
What about vasectomy, though? Is vasectomy reversal covered under Obamacare? Will it be covered by health insurance policies?
Is Vasectomy Reversal Covered Under Obamacare?
Unfortunately, the answer is no. Like tubal ligation and other permanent forms of contraception, reversal procedures are not deemed essential and therefore coverage is not mandatory. Many groups are advocating for further coverage for men where reproductive health and contraception are concerned, but thus far no changes have been made.
Does this Mean Vasectomy and Reversal aren’t Covered by Health Insurance?
Actually, no. Although health insurance providers are not mandated by law to offer coverage for procedures like male sterilization (or reversal), that doesn’t necessarily mean you will not have access to this coverage.
Many insurance providers included coverage for vasectomy, and in some cases reversal, prior to the enactment of the ACA. Some continue to provide this coverage even though they are not required to do so.
This means that men interested in receiving such coverage will have to comparison shop to find policies that include the coverage they prefer. In other words, the burden is on consumers to find the health insurance coverage that suits their particular needs.
What Does this Mean for Family Planning?
The intent of increasing coverage for women’s reproductive health was likely to provide women with greater decision-making power concerning reproduction. Unfortunately, failing to provide mandatory coverage for men in terms of contraception has shifted the burden for family planning to women in some cases.
Because a tubal ligation is a much more serious and invasive medical procedure than vasectomy (requiring general anesthesia and a hospital stay whereas vasectomy requires only local anesthesia and is an outpatient procedure), many couples prefer vasectomy. If money is a factor, though, these couples are more likely to opt for tubal ligation and the increased risk factors it entails.
Hopefully advocate groups will gain some traction in the coming years, convincing the government to include equal coverage for male contraceptive devices and procedures. Until then, careful planning can help individuals and couples to find the method of contraception that best suits their needs.