Two major provisions of the health-overhaul law take effect Wednesday, testing employers' ability to adapt to changes the measure mandates.
The law requires employers to distribute millions of dollars in insurance-company refunds to workers whose plans spent a high percentage of their premium dollars on administrative expenses instead of medical care.
Employers also will have to begin including contraception and other women's services in workers' insurance plans without charging employees co-payments or other fees.
The Department of Health and Human Services said Tuesday that it estimated from Census data that 47 million women between the ages of 15 and 64 were enrolled in private health insurance plans that are subject to the new requirement to cover contraception and other health services. It isn't clear how many women will actually use those services.
The requirement to cover birth control includes the so-called morning-after pill and sterilization. Insurance plans also will have to cover several other services for women without charging copayments, such as breast-feeding support and supplies and screening for gestational diabetes, HIV and domestic violence.