Biden Administration Proposes Expanded Access to Contraception

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Private insurers would have to cover all prescribed contraceptives without cost-sharing

by
Joyce Frieden, Washington Editor, MedPage Today
October 21, 2024

Roughly 52 million women with private health insurance will have increased access to contraception under a proposed rule announced Monday by the Biden administration.

“Since the Supreme Court overturned Roe v. Wade, reproductive healthcare has been under attack,” HHS Secretary Xavier Becerra said on a phone call with reporters Friday. “That means preventative services like contraception are more important than ever, and when healthcare plans and issuers impose unduly burdensome administrative or cost-sharing requirements for services, access to contraceptives becomes even more difficult.”

The proposed rule, issued by HHS and the departments of Labor and Treasury, would:

• Expand coverage of over-the-counter contraception without cost sharing. Under the proposed rule, women would be able to obtain over-the-counter (OTC) contraception without a prescription at no additional cost, according to a White House fact sheet. “As a result, more women would be able to access and afford critical OTC medications such as emergency contraception and the first-ever daily [OTC] oral contraceptive approved by the FDA,” the fact sheet noted.
• Make it easier to learn about coverage for OTC contraception. Most private health plans would be required to disclose that OTC contraception is covered without cost-sharing and without a prescription — and to help women learn more about their contraception coverage, the White House said.
• Strengthen coverage of prescribed contraception without cost-sharing. The proposed rule would make it easier for most women with private health insurance to obtain prescription contraception without cost-sharing. Health insurers would be required to cover every FDA-approved contraceptive drug or drug-led combination product without cost-sharing unless the plan also covers a therapeutic equivalent without cost-sharing.

“Dangerous and extreme abortion bans are putting women’s health and lives at risk and disrupting access to critical healthcare services, including contraception, as healthcare providers are forced to close,” Jennifer Klein, director of the Gender Policy Council at the White House, said on the call. “In states across the country, Republican elected officials in states have made clear that they plan to ban or restrict birth control in addition to abortion, and Republicans in Congress have proposed to defund Title X family planning and have blocked federal legislation that would safeguard nationwide access to contraception.” The proposed rule represents “the most significant expansion of contraception coverage under the Affordable Care Act in more than a decade,” she added.

Becerra noted that “We have heard from women who need a specific brand of birth control, but the cost of their prescription isn’t covered by their health insurance. We have made clear that in all 50 states, the Affordable Care Act guarantees coverage of women’s preventative services … including all birth control methods approved by the FDA.”

President Biden also weighed in on the rule. “At a time when contraception access is under attack, Vice President Harris and I are resolute in our commitment to expanding access to quality, affordable contraception,” he said in a statement. “We believe that women in every state must have the freedom to make deeply personal healthcare decisions, including the right to decide if and when to start or grow their family. We will continue to fight to protect access to reproductive healthcare and call on Congress to restore reproductive freedom and safeguard the right to contraception once and for all.”

On the call, Becerra added that in addition to the contraception provisions, HHS and the Labor and Treasury departments are issuing new guidance “to help ensure that consumers can access other recommended preventative services without cost-sharing. This new guidance will address barriers and challenges related to coverage of preventative services like pre-exposure prophylaxis (PrEP) and colonoscopies that must be covered under the Affordable Care Act.”