Biden administration to propose expanding access to over-the-counter contraception at no cost

The Biden administration is set to propose a new rule Monday that would require private insurance plans to cover over-the-counter contraception without a prescription at no cost.

Jen Klein, the director of the White House Gender Policy Council, called the proposal “the most significant expansion of contraception coverage under the Affordable Care Act in more than a decade.”

Reproductive health has emerged as a key issue in the race for the White House in the wake of the Supreme Court’s 2022 decision overturning Roe v. Wade. Democrats are warning that the decision put access to fertility treatments and contraception at risk in red states across the country. A Democratic-backed measure to codify contraception access failed to pass the Senate in June.

On the campaign trail, Vice President Kamala Harris has warned that Donald Trump would gut reproductive health access if returned to the White House. The former president, meanwhile, said he would not support restricting birth control shortly after claiming he was “looking at” contraceptives when asked whether he supported any restrictions to the right to contraception.

“Dangerous and extreme abortion bans are putting women’s health and lives at risk and disrupting access to critical health care services, including contraception, as health care providers are forced to close in states across the country,” Klein warned on a Friday call with reporters previewing the rule, adding that “Republican elected officials in states have made clear that they plan to ban or restrict birth control in addition to abortion.”

The Affordable Care Act requires that most private health plans cover contraception with no cost-sharing. But insurers are allowed to require a prescription for over-the-counter contraception at no cost.

Under the proposed rule, women would not need a prescription to obtain at no cost over-the-counter contraception, such as the Plan B emergency contraceptive, spermicide and Opill, the first nonprescription daily oral contraceptive approved by the Food and Drug Administration, an administration official said.

The proposed rule would also mandate insurers cover all FDA-approved drugs and drug-led combination products, unless the plans also cover a therapeutic equivalent. Therapeutic equivalents, according to the FDA, are drugs that contain an identical amount of the same active ingredient. Currently, insurers have to cover only one drug per category of contraception — whether it is birth control pills, implants or IUDs — leading some women to have trouble accessing the specific combination of drugs in the type of prescription contraceptive they want, the official said.

The proposed rule would affect an estimated 52 million women of reproductive age with private insurance plans, according to the official.

“Since the Supreme Court overturned Roe v. Wade, reproductive health care has been under attack,” Health and Human Services Secretary Xavier Becerra told reporters Friday. “That means preventative services like contraception are more important than ever. And when health care plans and issuers impose unduly burdensome administrative or cost sharing requirements for services, access to contraceptives becomes even more difficult.”

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