White House Takes Bold Step to Erase Out-of-Pocket Birth Control Costs for Millions

The Biden administration unveiled a groundbreaking plan on Monday aimed at eliminating out-of-pocket costs for most birth control for a substantial portion of the American population. This proposed regulation, targeting those with private health insurance, represents the most significant enhancement of contraception coverage under the Affordable Care Act (ACA) in over a decade. Approximately 52 million women of reproductive age stand to benefit from these changes.

Jennifer Klein, director of the White House Gender Policy Council, highlighted the historic nature of the initiative, stating, “For the first time ever, women would be able to obtain over-the-counter contraception without a prescription at no additional cost.” The rule would also require health plans to cover a wider range of prescribed contraceptives without cost-sharing.

This reform seeks to alleviate the financial strain many Americans face regarding birth control. Since the ACA’s implementation in 2010, private health plans have been obligated to cover at least one form of contraception without out-of-pocket expenses. Research indicates that this mandate has led to increased contraceptive use and a reduction in both women’s healthcare costs and unintended pregnancies.

The proposed rule aims to address barriers to accessing over-the-counter contraceptive methods. If approved, it would require coverage for various birth control methods typically purchased without a prescription, including condoms and emergency contraception. Additionally, it includes the new over-the-counter hormonal birth control pill, Opill, which has recently become available retail at an estimated cost of $90 for a six-month supply.

There have been persistent calls from Democrats to enhance enforcement of the existing ACA contraceptive mandate, as multiple reports reveal negligent enforcement resulted in women receiving unexpected bills for covered contraceptive methods. A 2021 KFF survey discovered that one in five women with private insurance had incurred out-of-pocket expenses for birth control.

Health and Human Services Secretary Xavier Becerra emphasized the administration’s commitment to ensuring all FDA-approved contraceptives are accessible without cost, addressing situations where insurance providers cover only a limited number of options within each category. “This proposed rule will build on the progress we have already made under the Affordable Care Act,” Becerra remarked. “We have made clear that in all 50 states, the ACA guarantees coverage of women’s preventive services without cost-sharing, including all birth control methods approved by the FDA.”

Reproductive rights remain a central focus for Vice President Kamala Harris, who has consistently advocated for improved access to contraception and family planning services, especially following the Supreme Court’s decision to overturn Roe v. Wade. Klein pointed out the impact of stringent abortion laws on women’s health, stating, “Dangerous and extreme abortion bans are putting women’s health and lives at risk.”

In juxtaposition, some Republican state lawmakers have expressed their intentions to restrict both birth control and abortion access, with calls to defund family planning programs like Title X. Harris has countered these views by asserting that “contraception is health care” and has addressed the implications of limiting women’s health care in over 100 events since Roe’s reversal.

The proposed regulation will enter a 60-day comment period before finalization, with officials noting its potential approval might extend into 2025. This timeline raises questions about its future, particularly if former President Donald Trump reclaims office. His position on contraception remains ambiguous, although certain affiliations with Project 2025 demonstrate support for restraining some contraceptive methods.

On the same day, agencies including Health and Human Services, Labor, and Treasury issued guidance to ensure consumers can access essential preventive services without cost-sharing, encompassing medications like Pre-Exposure Prophylaxis (PrEP) and colonoscopies covered under the ACA.