The Biden-Harris Administration recently proposed a rule expanding contraceptive coverage under the Affordable Care Act. Nearly 50 million Americans utilize the Affordable Care Act’s Marketplace for affordable healthcare insurance. The Affordable Care Act also protects over 100 million Americans with pre-existing conditions. On average, American families who use the Marketplace to acquire healthcare coverage save $800 per year.
Notably, the Affordable Care Act also provides millions of women with coverage for contraceptives, saving women billions. The Biden-Harris Administration’s proposed rule would expand the Affordable Care Act’s reach in the area of contraceptives, allowing for coverage of contraceptives purchased over-the-counter.
Currently, under the Affordable Care Act, private health plans must cover the complete cost-sharing of contraceptives prescribed by a provider. In other words, health plans must pay the full amount of all contraceptives accessed by their beneficiaries when prescribed by their healthcare provider. Under the new proposed rule, private health plans would be required to provide coverage for over-the-counter contraceptives, no longer requiring beneficiaries to obtain a provider’s prescription to get their contraceptives. Over-the-counter contraceptives include emergency contraceptives, such as the ‘morning after’ pill. Additionally, the proposed rule would expand the current list of contraceptives that private health plans are required to cover at no cost-sharing to beneficiaries. In sum, the proposed rule would greatly expand the already expansive Affordable Care Act relating to contraceptives.
The proposed rule comes off the heels of Republican congress members’ advocacy to defund the Title X Family Planning Program. Additionally, abortion rights and contraceptive access have been limited over the past years following the overturn of Roe v. Wade. Republican lawmakers advocate for reducing the amount of funds the federal government provides to abortion providers and contraceptive coverage. Specifically, following Donald Trump’s electoral victory these past weeks, Vice President-elect JD Vance has stated that “we don’t think that taxpayers should fund late-term abortions”, emphasizing the incoming administration’s desire to defund and minimize coverage for family planning. In turn, this would leave government protections and financial coverage of abortions and contraceptives to the states and private insurers.
On the other side, the Biden-Harris Administration has made clear its commitment to providing expansive and robust coverage for family planning services. However, as the administration changes with the incoming President-elect Donald Trump taking control, the future of women’s health and family planning remains uncertain. While the Biden-Harris Administration seeks to create a final, agency rule expanding the protection of contraceptive coverage, the incoming Trump Administration has signaled its desire to utilize Executive Orders to roll back Biden-Harris Administration rules. In sum, the future of contraceptive coverage, both under the Affordable Care Act and through private health insurers, remains vulnerable to significant rollbacks.