Biden-Harris Administration Proposes New Rules to Expand Access to Birth Control Coverage Under the Affordable Care Act
Today, the U.S. Department of Health & Human Services (HHS) and the Departments of Labor and the Treasury (Departments) proposed a rule to strengthen access to birth control coverage under the Affordable Care Act (ACA). Under the ACA, most plans are required to offer coverage of birth control with no out-of-pocket cost. To date, millions of women have benefited from this coverage. Today’s rule proposes to expand and strengthen access to this coverage so that all women who need or want birth control are able to obtain it. The action is the latest effort by the Biden-Harris Administration to bolster access to birth control at no cost.
The ACA and its implementing regulations guarantee coverage of women’s preventive services, including birth control and contraceptive counseling, at no cost for women who are enrolled in group health plans or individual health insurance coverage.
“Now more than ever, access to and coverage of birth control is critical as the Biden-Harris Administration works to help ensure women everywhere can get the contraception they need, when they need it, and – thanks to the ACA – with no out-of-pocket cost,” said HHS Secretary Xavier Becerra. “Today’s proposed rule works to ensure that the tens of millions of women across the country who have and will benefit from the ACA will be protected. It says to women across the country, we have your back.”
“We know that access to affordable health care is vital. HHS, along with the Department of Labor and the Department of the Treasury, continues to protect and promote access to the reproductive health care services people need, including contraception” said CMS Administrator Chiquita Brooks-LaSure. “If this rule is finalized, individuals who have health plans that would otherwise be subject to the ACA preventive services requirements but have not covered contraceptive services because of a moral or religious objection, would now have access.”
In 2018, final regulations expanded exemptions for religious beliefs and moral convictions allowing private health plans and insurers to exclude coverage of contraceptive services. The proposed rules released today would remove the moral exemption and retain the existing religious exemption. The 2018 rules include an optional accommodation that allows objecting employers and private colleges and universities to completely remove themselves from providing birth control coverage while ensuring women and covered dependents enrolled in their plans can access contraceptive services at no additional charge. Under the 2018 rules, these women and covered dependents would get this contraceptive access only if their employer or college or university voluntarily elects the accommodation—leaving many without access to no-cost contraceptives.
The proposed rules seek to ensure broader access to contraceptive services by creating an independent pathway for individuals enrolled in plans arranged or offered by objecting entities to make their own choice to access contraceptive services directly through a willing contraceptive provider without any cost. This would allow women and covered dependents to navigate their own care and still obtain birth control at no cost in the event their plan or insurer has a religious exemption and, if eligible, has not elected the optional accommodation. The proposed rules would leave in place the existing religious exemption for entities and individuals with objections, as well as the optional accommodation for coverage.
The proposed rules are part of the Biden-Harris Administration’s commitment to ensuring access to reproductive health care and follows earlier action to expand access to birth control and family planning services. HHS, the Department of Labor, and the Department of the Treasury previously convened a meeting with health insurers and called on the industry to commit to meeting their obligations to provide contraceptive coverage as required by the ACA. The Departments also issued guidance to clarify protections for birth control coverage under the ACA following multiple states’ efforts to restrict access to contraception in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. HHS also announced nearly $3 million in new funding to bolster training and technical assistance for the nationwide network of Title X family planning providers.
The U.S. Supreme Court’s decision in Dobbs has placed a heightened importance on access to contraceptive services nationwide. HHS released a report in August on actions taken to ensure access to reproductive health care, including contraception, following the Supreme Court’s ruling, with further details on future actions and commitments. Read the report “Secretary’s Report: Health Care Under Attack: An Action Plan to Protect and Strengthen Reproductive Care - PDF.”
To learn more about the care available to patients and their right to that care, visit ReproductiveRights.gov.
For more information on the proposed rules, consult the fact sheet available at https://www.cms.gov/newsroom/fact-sheets/coverage-certain-preventive-services-under-affordable-care-act-proposed-rules.
To review or comment on the proposed rules during its 60-day public comment period, visit the Federal Register.
In addition, HHS also recently released a report entitled: “Marking the 50th Anniversary of Roe: Biden-Harris Administration Efforts to Protect Reproductive Health Care,” which outlines the actions HHS has taken in the face of the health crisis precipitated by the Dobbs decision.
HHS actions have been centered on six core priorities:
- Protecting Access to Abortion Services
- Safeguarding Access to Birth Control
- Protecting Patient Privacy
- Promoting Access to Accurate Information
- Ensuring Non-discrimination in Healthcare Delivery
- Evidence-Based Decision Making at FDA
The full report can be read at https://www.hhs.gov/sites/default/files/roe-report.pdf - PDF.