Proposed rules would amend current law to require full coverage of nonprescription birth control pills.
New rules proposed by the Biden administration would require health insurers to cover certain over-the-counter contraceptives without a prescription at no cost to patients.
The proposed regulations would require coverage of nonprescription birth control pills—recently approved by the Food and Drug Administration (FDA)—as well as condoms, emergency contraceptives, and spermicides under the Affordable Care Act.
The rules would not change federal conscience protections for employers and insurers that oppose contraception on moral grounds.
“At a time when contraception access is under attack, Vice President [Kamala] Harris and I are resolute in our commitment to expanding access to quality, affordable contraception,” President Joe Biden said in an Oct. 21 statement.
“We believe that women in every state must have the freedom to make deeply personal health care decisions, including the right to decide if and when to start or grow their family.”
The proposal was made just two weeks before the presidential election; Harris, the Democratic nominee, has made reproductive issues a focal point of her campaign.
Heralding the proposed regulations as “the largest expansion of contraception coverage in more than a decade,” the vice president said in a statement that they would provide “millions of women with more options for the affordable contraception they need and deserve.”
The Affordable Care Act already requires most private insurers to cover prescription birth control pills at no cost to patients. The law does not include nonprescription birth control, which the FDA approved for the first time in July 2023 with its approval of Opill.
The move to expand coverage of contraception followed the 2022 Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturning the federal right to an abortion. Democrats have pointed to some states’ tightening of abortion restrictions in the wake of that ruling as reason to fear similar restrictions on access to contraceptives.
In June, Senate Democrats put forward a bill to establish a federal right to contraception. That bill was ultimately blocked by Republicans, who noted that contraception is widely available in all 50 states.
“It’s not that they believe there is a problem they’re truly trying to solve. They’re prioritizing their own short-term partisan political interests,” Sen. Katie Britt (R-Ala.) said at the time, accusing her colleagues of carrying out a “summer of scare tactics” ahead of the presidential election.
Some states, such as Missouri, have sought to restrict public funding of birth control, which some taxpayers oppose on principle. However, there have been no recent efforts to ban or restrict the use of contraceptives by any state.