White House Scraps Initiative Mandating Health Insurance for Over-the-Counter Birth Control

The White House has officially withdrawn a proposed rule that aimed to mandate private health insurance plans cover over-the-counter birth control. This decision will be documented in the Federal Register on Wednesday.

Initially announced in October, this rule had the potential to benefit approximately 52 million women of reproductive age. White House officials described it as the most significant enhancement of contraception coverage under the Affordable Care Act (ACA) in over a decade.

The proposed regulation sought to leverage the ACA, which requires health insurers to cover at least one form of each contraceptive method at no cost to patients. Since its implementation in 2012, the mandate has significantly influenced women’s birth control usage, including more effective options like intrauterine devices. Studies sometimes link this coverage with reductions in unintended pregnancies, particularly benefiting women from lower-income backgrounds.

However, persistent concerns about enforcement remained. Reports indicated that many women still received unexpected bills for their birth control despite the supposed coverage. A 2021 KFF survey revealed that 20% of women with private insurance had incurred out-of-pocket costs for contraceptives.

Notably, the existing contraceptive coverage mandate does not extend to condoms, emergency contraception, or the newly available over-the-counter hormonal pill, Opill, which retails at approximately $90 for a six-month supply. The proposed rule aimed to enhance coverage for these items as well.

The announcement was strategically timed amid a presidential campaign, where Democrats elevated reproductive rights as a critical issue. Yet, with the regulatory process being lengthy, the Biden administration was required to collect public feedback after proposing the rule, a comment period that concluded on December 27. The administration reportedly received over 250 public comments before deciding to withdraw the proposal.

According to the notice, “The Departments have determined it is appropriate to withdraw the proposed rules at this time, focusing instead on other matters.” No comments were provided by White House representatives.

Even in fall, officials anticipated that the new birth control rule wouldn’t be implemented until 2025, raising concerns about its future viability if Donald Trump were to regain the presidency. With Trump soon to resume office, chances of expanding the birth control mandate appear slim. His administration previously undertook measures to diminish the ACA’s contraceptive coverage.

Moreover, ongoing threats to contraceptive coverage may arise from other government branches. The Supreme Court is set to deliberate on a case challenging the ACA’s preventive services mandate, which not only encompasses birth control but also essential health services like vaccinations and mental health screenings. Given the court’s conservative majority, there is potential for weakening the ACA’s protective measures further.