David Engler had been pretty sure he didn’t want children. Then a frustrating school day two years ago helped seal the deal for the now 43-year-old substitute teacher. This story also ran on .
It can be . “It was wild. I had to call the office seven times to get kids pulled out,” he said.
“The next day, I called Kaiser and said, ‘I’d like to know how much a vasectomy is.’” A representative with Engler’s insurer, Kaiser Permanente, told him the procedure would be free because it was a form of birth control, he said. But after undergoing the vasectomy last winter, he received a bill for $1,080.
“I felt defeated, tricked, and frustrated,” said Engler, who lives in Portland, Oregon. Engler’s experience highlights how a labyrinthine patchwork of insurance coverage rules on reproductive health care creates confusion for patients. Oregon requires that vasectomies be covered for most people who work in the public sector.
But the federal Affordable Care Act — which mandates that most health plans cover preventive health services, such as contraception, at no cost to the consumer — does not require vasectomies to be covered. And that perplexity surrounding coverage may get more complicated. An ongoing federal lawsuit aims to strike down the ACA’s preventive care coverage requirements for private insurers.
If the case knocks out the mandates, state-level laws — which vary widely across the country — would carry more weight, a change that would resume th.