CBS News
Insurance wouldn’t pay for his vasectomy. Such birth control coverage may become more elusive.
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.
“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 the “wild West” dynamic from before Obamacare, said Zachary Baron, a health policy researcher at Georgetown Law.
It would create an environment “in which insurers and employers pick and choose which services they want to cover or which services they want to charge for,” Baron said. “It would certainly threaten access to care for millions of Americans.”
Studies have shown the requirements to cover preventive care have reduced consumers’ out-of-pocket costs and increased their use of short- and long-term birth control methods.
The job of defining which contraceptive services should be covered falls to the Health Resources and Services Administration, or HRSA. Two other groups — the U.S. Preventive Services Task Force, or USPSTF, and the Advisory Committee on Immunization Practices, or ACIP — make recommendations on other kinds of care that the ACA requires insurers to cover.
The plaintiffs in the lawsuit, a group of individuals and Christian-owned businesses, argue the members of these three panels haven’t been properly appointed by Congress. They also say the recommendations for insurance plans to cover medication for HIV prevention violate their religious rights.
On June 21, the U.S. Court of Appeals for the 5th Circuit issued what it called a “mixed bag” opinion in the case. It said one group — the USPSTF — had not been properly appointed, and therefore its recommendations made after the ACA was signed into law were unconstitutional. The plaintiffs had asked for a nationwide ruling, but the court said only the plaintiffs’ organizations could be exempted from its recommendations.
The court then sent the plaintiffs’ challenges to the recommendations made by HRSA and ACIP — including those on contraception — back to a lower court to consider.
The case is likely headed to Reed O’Connor, a federal judge in Texas who has issued decisions undermining the ACA — including a ruling striking down the entire law that the U.S. Supreme Court later overturned.
“O’Connor is a judge notoriously hostile to the Affordable Care Act,” said Gretchen Borchelt, vice president of reproductive rights and health at the National Women’s Law Center. “He is someone who is willing to impose remedies where he takes access to care away from everybody in the country based on what’s happening in one situation.”
A win for the plaintiffs, she worried, could create confusion about what kind of contraception is covered and how much it costs, which would ultimately lead to more unintended pregnancies — all at a time when women have less access to abortions.
Nearly two dozen organizations — including the American Medical Association, the American Public Health Association and the Blue Cross Blue Shield Association — have joined Borchelt’s group in filing briefs warning about the potential disruptions a ruling for the plaintiffs could cause.
Jay Carson, an attorney with the Buckeye Institute, a conservative think tank, said he’s happy with the court’s ruling. His group, along with the state of Texas, filed briefs in support of the plaintiffs.
“Unelected bureaucrats” shouldn’t have the power to decide what insurance plans should be required to cover, said Carson. “We’ve gotten so far afield of Congress actually making the laws and, instead, relying on Congress to just empower some agency to do the heavy lifting.”
What power agencies do have is likely to be curtailed in the wake of a June 28 U.S. Supreme Court decision that overturned a decades-old precedent dictating that courts should defer to federal agencies when it comes to regulatory or scientific decisions.
“Courts are going to be more able to scrutinize experts,” said Richard Hughes, a health care regulatory attorney with the firm Epstein, Becker, and Green. “It’s a vibe shift — we’re moving in the direction of the administrative state being curtailed.”
Eliminating federal coverage requirements for contraception would leave it up to states to determine what services health insurance plans would be required to provide.
Fourteen states and Washington, D.C., currently protect the right to contraception. But states can go only so far with those rules, said Baron, because a federal statute prevents them from regulating self-funded health plans, which cover about 65% of workers.
“It would leave significant gaps in coverage,” Baron said.
A group of Democratic-led states made such an argument in a court brief last year, arguing for the mandates to be upheld to discourage self-funded plans from declining to offer preventive services, as they often did before the ACA.
Even when states can regulate what health plans cover, people still fall through the cracks. “I see denials all the time in instances where the treatment clearly is covered,” said Megan Glor, a health insurance attorney in Oregon.
Patients can appeal their insurers’ decisions, but that’s not easy. And if a patient’s appeals fail, litigation is generally the only option — but that’s a long, complicated, costly process, Glor said. Likely, the best outcome for a patient is an insurer covering what should have been covered in the first place.
When Engler called Kaiser Permanente about his vasectomy charge, he said a representative told him the bill was sent by mistake. Still, he said, the insurer kept asking for money. Engler filed and lost multiple appeals and eventually settled the charge for $540.
Kristina Barker for KFF Health News
Engler’s vasectomy likely should have been free, Glor said. As a teacher, Engler is a public sector employee, which means his insurance would be subject to an Oregon law that mandates no-cost coverage for vasectomies.
Kaiser Permanente told KFF Health News that state law does not apply because of a federal rule for high-deductible health plans paired with health savings accounts. That rule requires patients to cover out-of-pocket costs until their deductible is met.
However, after KFF Health News contacted Kaiser Permanente about Engler’s situation, he said the company promised to issue a full refund for the $540 he had paid to settle his case.
“Although we administered the benefit correctly, an employee who spoke with Mr. Engler told him incorrectly that he would not have” to share the cost, said Debbie Karman, a Kaiser Permanente spokesperson.
Engler said he’s happy with the outcome, though he’s still unsure how Kaiser Permanente’s staff was confused about his insurance coverage.
He worries that others don’t have the means he had to advocate for himself.
“It’s scary,” he said. “So many people are limited in their resources or their understanding of how to fight — or even who to fight.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling and journalism.
Kyiv, Ukraine — Russia launched dozens of missiles at cities across Ukraine on Monday in an attack that killed at least 20 people people and smashed into a children’s hospital in Kyiv, officials said. The rare day-time Russian barrage came as President Volodymyr Zelenskyy was due in Warsaw, the Polish government said, before he flies to a NATO summit in Washington.
Explosions rang out and black smoke could be seen rising from the centre of Kyiv, AFP journalists reported.
Pictures distributed by officials from the children’s medical facility in Kyiv showed people digging through mounds of rubble, black smoke billowing over a gutted building and medical staff wearing blood-stained scrubs.
“Russian terrorists once again massively attacked Ukraine with missiles. Different cities: Kyiv, Dnipro, Kryvyi Rig, Sloviansk, Kramatorsk,” Zelenskyy said, listing major civilians hubs in the south and east of the country.
“More than 40 missiles of various types. Residential buildings, infrastructure and a children’s hospital were damaged,” he wrote on social media.
Gleb Garanich/REUTERS
Zelenskyy said that there were an unknown number of people trapped under the rubble of the Okhmatdyt children’s hospital and it was not immediately clear how many had been killed.
Municipal officials said earlier that at least seven people had been killed in the barrage that hit Kyiv.
Russian forces have repeatedly targeted the capital with massive barrages since Moscow invaded Ukraine in February 2022, and the last major attack on Kyiv with drones and missiles was last month. In addition to the continuous aerial bombardment of Ukraine’s cities and power infrastructure, Russia has also pushed its territorial gains in recent months, making incremental advances along the front line that stretches from Ukraine’s northern to southern borders.
In Zelenskyy’s hometown Kryvyi Rih, which has been repeatedly targed by Russian bombardments, the strikes killed at least 10 and wounded over 30, the mayor said.
“In Dnipro, a high-rise building and an enterprise were damaged. A service station was damaged. There are wounded,” the Dnipropetrovsk governor Sergiy Lysak added.
In the eastern Donetsk region, where Russian forces have taken a string of villages in recent weeks, the regional governor said three people were killed in Pokrovsk — a town that had a pre-war population of around 60,000 people.
There was no immedate comment on the strikes from the Kremlin but it insists its forces do not target civilian infrastructure.
Gleb Garanich/REUTERS
“This shelling targeted civilians, hit infrastructure, and the whole world should see today the consequences of terror, which can only be responded to by force,” the head of the presidential administration in Kyiv, Andriy Yermak, wrote on social media, following the attack.
Zelenskyy and other officials in Kyiv have been urging Ukraine’s allies to send more air defence systems, including Patriots, to the war-battered country to help fend off fatal Russian aerial bombardments.
“Russia cannot claim ignorance of where its missiles are flying and must be held fully accountable for all its crimes,” Zelensky said in another post on social media.
CBS News
Biden campaign ramping up outreach to lawmakers amid concerns about whether he should stay on the ticket
Ahead of a potentially pivotal week on Capitol Hill, the Biden-Harris campaign is stepping up its outreach to lawmakers amid growing calls for President Biden to step down from the ticket. Mr. Biden has personally made 20 calls to congressional members since last month’s presidential debate in Atlanta and additional calls are expected, a campaign official confirms to CBS News.
Last week, the White House said the president spoke with several key allies including Senate Majority Leader Chuck Schumer, House Minority Leader Hakeem Jeffries, Speaker Emerita Nancy Pelosi, Rep. Jim Clyburn of South Carolina and Sen. Chris Coons of Delaware. Vermont Senator Bernie Sanders also told Face The Nation Sunday that he had recently spoken with the president.
A memo acquired by CBS News, which was sent to Hill offices by the Biden-Harris campaign, highlights more than a dozen appearances by the president since the debate in “blue wall states,” including this weekend’s campaign events in Wisconsin and Pennsylvania. On Sunday, Mr. Biden spoke at Philadelphia church, stopped by a field office with Sen. John Fetterman of Pennsylvania to rally volunteers and joined Pennsylvania Gov. Josh Shapiro at a coffee shop in Harrisburg.
SAUL LOEB / AFP via Getty Images
“I’m up to the job,” Biden, 81, told reporters before departing the Keystone State on Air Force One.
The memo outlines Mr. Biden’s upcoming schedule this week, which features the NATO summit, a meeting with union leaders at the AFL-CIO Wednesday and a campaign event in Detroit Friday. It points to a new Bloomberg/Morning Consult poll that shows Mr. Biden narrowing the gap to 45%-47% against former President Donald Trump in seven key battleground states. It also boasts support from surrogates and grassroots donors, citing June as its “best” fundraising month with a $127 million haul.
“Since the debate, we’ve seen an outpouring of robust and continually growing grassroots support, sending a clear message – Americans understand the stakes and are fired-up and ready to re-elect Joe Biden and Kamala Harris,” the memo reads.
The effort follows a Sunday afternoon leadership call with ranking members from various House committees. Several senior House Democrats said the President should end his re-election campaign in the wake of his recent debate performance, multiple people tell CBS News.
At least five House Democrats have called on the president to step down as the party nominee. Virginia Sen. Mark Warner scrapped a Monday meeting with a group of Senate Democrats to discuss the President’s bid, a source familiar with the senator’s thinking confirmed to CBS News.
House and Senate Democrats are expected to hold separate meetings Tuesday where Biden’s embattled presidential campaign is likely to come up.
“I’ve got a wait and see position to see how things go,” one House Democrat told CBS News. “I think most people just want to continue to see how the president does.”
— additional reporting by Nancy Cordes.
CBS News
Walmart’s rival Amazon Prime Day sale starts today. Here are our 9 top deal picks to shop now
Walmart
While most eyes are on Amazon Prime Day, starting next week and running from July 16-17, 2024, you don’t want to miss Walmart’s rival sale. Called Walmart Deals, Walmart’s anti-Prime Day sale features slashed prices on some of your favorite products from Dyson, GE, Keurig and more.
There’s no need to wait until Prime Day to save: Walmart Deals starts today and the deals are pretty intense. Like past Walmart sales events, we expect the best deals on back-to-school basics, electronics and more to sell out quick.
Keep reading for our take on the hottest deals happening on Walmart Deals, plus learn what you need to know to get early access to the biggest Walmart sale of 2024 so far.
When does Walmart’s rival Prime Day sale start?
Move over, Amazon Prime Day: The Walmart Deals 2024 sale starts on Monday, July 8, 2024. Expect big savings on back-to-school necessities, camping gear, home essentials and more.
The Walmart Deals sale opens to the general public at 5:00 p.m. ET (2:00 p.m. PT). Paid Walmart+ subscribers get five hours of early access to shopping all of today’s deals, including those we’ve listed below. They can start shopping the Walmart Deals sale starting at noon ET (9:00 a.m. PT) on Monday.
Walmart+ is on sale: Subscribe for half price
If you’re not a Walmart+ subscriber yet, Walmart Deals week is the best time to join. That’s because Walmart is offering Walmart+ memberships for half price this week. You can get your first year of Walmart+ for just $49. (Walmart+ is regularly $98 per year.)
Not only do Walmart+ members get early access to Walmart Deals, members get free delivery from their local Walmart store, returns picked up from home, member savings on fuel and a complimentary subscription to the Paramount+ streaming service, which gives subscribers access to all NFL games airing on CBS next season.
Tap the button below to get in on this Walmart+ deal while it lasts. Hurry, the Walmart+ deal is good this week only.
Walmart Deals best deals
Walmart is pulling out all stops, offering slashed prices on top-selling products. Below are the hottest deals of Walmart Deals.
TCL 65″ Class Q 4K QLED with Google TV: $398 (save $100)
Walmart
Get ready for the 2024 NFL season with a great deal on a top-notch TV. TCL’s Q Class TV offers premium picture quality featuring QLED Quantum Dot technology and HDR Pro+ with Dolby vision, ensuring a high-quality picture with enhanced contrast, colors and details.
This budget TV’s high-brightness direct LED backlight delivers brighter images, while TV’s auto game mode optimizes the picture for responsive gameplay without lag. A standout TV for movie lovers, sports fans and gamers alike, this TV is a great pick for the price.
Get this TV during Walmart Deals for $398, reduced from $498.
Dyson V12 Detect Slim cordless vacuum cleaner: Save $200
Walmart
Beauty influencers have long touted Dyson’s heat-minimizing Airwrap styler. Now Dyson deal lovers can clean up with big savings on the brand’s popular slim vacuum at the Walmart Deals sale.
Dyson’s lightest intelligent cordless vacuum, the versatile Dyson V12 Detect Slim can deep clean your home, finding otherwise invisible dust on hard floors. The machine optimizes run time based on debris picked up, tracking it on the LCD screen. The screen also displays a run-time countdown and maintenance alerts.
We like the de-tangling cleaner head, which deep cleans carpets and hardwood floors without getting stopped up on pet hair. It comes with a two-year warranty.
The Dyson Slim vacuum cleaner is on sale during the Walmart Deals sale for $450, reduced from $650.
Keurig K-Slim + ICED single-serve coffee maker: $49 (save $80)
Walmart
Whether you’re looking for full-flavored coffee to start your day, or a refreshing iced coffee post-lunch, Keurig’s K-Slim coffee maker delivers one great cup of coffee after the next. It’s less than half price during the Walmart Deals summer sale.
This machine can automatically adjust brew temperature to create the perfect iced coffee, starting hotter to maximize flavor, then cooling down so less of your ice melts. It makes drinks in just two minutes in your choice of three cup sizes.
The Keurig K-Slim makes up to four eight-ounce cups before the 46-ounce reservoir needs refilling.
This Keurig coffee maker will be $49 at the Walmart Deals sale, reduced from $129.
Aovopro ES80 350W foldable electric scooter: Save $200
Walmart
What a deal on a terrific scooter suited for both kids and adults! This electric scooter features an extended range and higher top speed, making it best suited for experienced riders.
This waterproof scooter offers three drive modes, a powerful battery for longer rides and an indicator that helps track battery life. The night light powers off automatically, saving your battery from getting drained.
Cruise through town at 19 mph thanks to the powerful 350-watt motor. Ride over 20 miles on a single charge and maximize stability on the 8.5-inch anti-skid tires. Front and rear dual brakes help keep riders safe. The scooter folds when not in use.
This scooter is $239 at the Walmart Deals sale, reduced from $439.
Lego Star Wars Hoth AT-ST building kit: Save $15
Walmart
There’s no age limit on Lego fandom or Star Wars fandom, and this Star Wars Hoth building kit scratches both itches. The Battle of Hoth AT-ST model from the ‘Star Wars: The Empire Strikes Back’ set (75322) includes 586 pieces. It’s guaranteed to provide endless hours of fun..
The AT-ST toy walker features an opening hatch and roof to the cockpit, two spring-loaded shooters and poseable legs. The set includes three Lego Star Wars mini figurines and offers easy-to-follow directions.
This Lego set is $35 during the Walmart Deals sale, reduced from $50.
Philips Sonicare Diamond Clean 9000 special edition rechargeable toothbrush: Save $50
Walmart
Remove up to 10 times more plaque than a manual toothbrush with the Phillips Sonicare Diamond Clean 9000 special edition rechargeable toothbrush. It features a pressure sensor, four brushing modes and three intensities.
The toothbrush sits on an elegant charging glass. Use the Sonicare App to track your brushing and ensure you’re on the path to reaching your oral health care goals.
This electric toothbrush is $150 during the Walmart Deals sale, reduced from $200.
Travelhouse three-piece luggage set: Save $35
Walmart
This three-piece hardshell expandable luggage set is lightweight and features spinner wheels. The set, which comes in nine different color choices, includes one (each) 20-inch, 24-inch and 28-inch suitcases, each with a three-step telescoping handle, quiet spinner wheels and a TSA-approved lock.
If you’re looking for an inexpensive luggage set for your summer travels, this is it. The Travelhouse three-piece luggage set is $85 at the Walmart Deals sale, reduced from $120.
Nintendo Super Mario Party with Red & Blue Joy-Con bundle: Save $30
Walmart
Save big on endless summer fun with the Nintendo Super Mario Party + Red & Blue Joy-Con bundle — the controllers alone are a $40 value.
This bundle includes a full game download and a pair of red (left) and blue (right) controllers for your Nintendo Switch console. Add another pair of controllers (sold separately) to allow four people to play at once.
This gaming bundle is $69 during the Walmart Deals sale, reduced from $99.
Rayovac 1.5V 72-pack total AA batteries & AAA batteries: Save $20
Walmart
The Walmart Deals and Amazon Prime Day sales are great opportunities to stock up on household essentials like batteries. Walmart is offering this massive two-pack that includes 36 AA batteries and 36 AAA batteries for $20 total during Walmart Deals, reduced from $40.
Ideal batteries for flashlights and other highly used devices like remote controls and toys, these batteries feature a ten-year power guarantee, so you know they’ll retain their charge while in storage.
Get this 72-count battery pack for $20 at the Walmart Deals sale.
Do you need to be a Walmart+ member to shop the Walmart Deals sale?
While you need to be an Amazon Prime member to get the best deals at the Amazon Prime Day sale, you don’t need to be a Walmart+ member to get the best deals during the Walmart Deals sale. That said, we expect many of the best deals to sell out quickly once they’re made available to the general public, so becoming a paid Walmart+ subscriber before the sale will all but guarantee you access to all the best deals.
Ukraine says 20 killed, children’s hospital hit in major Russian missile attack
Biden campaign ramping up outreach to lawmakers amid concerns about whether he should stay on the ticket
Walmart’s rival Amazon Prime Day sale starts today. Here are our 9 top deal picks to shop now
Ukraine says 20 killed, children’s hospital hit in major Russian missile attack
Biden campaign ramping up outreach to lawmakers amid concerns about whether he should stay on the ticket