New rule proposes to expand access to birth control coverage

Photo: Luis Alvarez/Getty Images

Together, the Department of Health and Human Services and the Departments of Labor and the Treasury proposed a rule this week to strengthen access to birth control coverage under the Affordable Care Act.

Under the ACA, most plans are required to offer coverage of birth control with no out-of-pocket cost. The new 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 Biden administration framed the action as the latest effort 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.

WHAT'S THE IMPACT?

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 new proposed rules would remove the moral exemption and retain the existing religious exemption.

The 2018 rules also include an optional accommodation that allows objecting employers and private colleges and universities to exempt 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 Departments said.

The proposed rules seek to ensure broader access to contraceptive services by creating an independent pathway for people enrolled in plans offered by objecting entities to make their own choice to access contraceptive services directly through a willing contraceptive provider without any cost. 

This, the departments said, would allow women and covered dependents still to obtain birth control at no cost in the event their plan or insurer has a religious exemption, or has not elected the optional accommodation if eligible. 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 LARGER TREND

The departments have taken a number of actions to expand birth control access. Previously, they 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.

HHS released a report in August on actions taken to ensure access to reproductive healthcare, including contraception, following the Supreme Court's ruling, with further details on future actions and commitments.

Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com