Many women were thrilled when the Affordable Care Act became law in 2010, because it required insurance companies to cover a broad array of women's health services without any out-of-pocket costs.
Five years later, the requirement isn't being enforced, according to two new studies.
Health insurance plans around the country are failing to provide many of those legally mandated services including birth control and cancer screenings.
The studies by the National Women's Law Center looked at health plan coverage documents and consumer complaints in 15 states.
One of the studies focused on contraception, while the other looked at a range of women's health issues, including maternity care, breast-feeding support and other services.
The studies found some very clear violations of the law. Companies not complying with law's requirements in at least some states are Aetna, Cigna, Physicians Plus and Anthem Blue Cross Blue Shield. For example, Physicians Plus, a plan offered in Wisconsin in 2014, limited coverage of prenatal vitamins to women under the age of 42.
Several companies in the study refused to provide coverage for birth control for women over age 50, despite the fact that many women are able to get pregnant long after that. The report on required coverage of birth control found numerous instances where health plans impermissibly try to impose cost-sharing on all except generic products.
There are, however, no generic intrauterine devices, and in some cases women have a medical need for brand-name products. Many plans in the study also failed to cover costs associated with birth control, such as follow-up appointments. Study's authors say legislation is not needed, because they have that, but better enforcement is needed