The Biden-Harris administration announced on Monday sweeping changes to Obamacare rules to require the coverage of over-the-counter contraceptives , an effort billed as part of a broader effort to back abortion rights, which have been a central focus of Democrats in the 2024 election cycle .
The proposed rule from the Department of Health and Human Services , along with the Treasury and Labor Departments, would require that health insurance providers completely cover the costs of all birth control methods, including condoms, spermicide, and emergency contraception.
Senior administration officials squarely placed the new proposed rule in the context of the abortion rights battle that has ensued since the Dobbs v. Jackson Women’s Health Organization case was decided in June 2022.
“Sincere the Supreme Court overturned Roe v. Wade , reproductive healthcare has been under attack,” HHS Secretary Xavier Becerra told reporters. “That means preventative services like contraception are more important than ever.”
Insurance plans have been required to cover prescribed contraceptives under Obamacare for 14 years, but enforcement of the rules has been difficult.
In June, Sen. Bernie Sanders (I-VT), chairman of the Health, Education, Labor and Pensions committee, called for an investigation into health insurance providers that were not compliant with the law.
The mandate has also faced extensive litigation, including from private employers who successfully argued before the Supreme Court that it infringed their religious liberty.
Under existing rules, insurance plans are only required to cover one product within a particular class of prescription contraceptive methods, such as one brand of IUD. This can make it difficult for patients who are prescribed a method for a particular medical reason but it is not covered by their insurance.
In addition to requiring coverage of over-the-counter products, the Biden-Harris administration’s new rule will require insurers to cover all contraceptive drugs and drug-led combination products approved by the Food and Drug Administration unless there is a therapeutic equivalent.
The rule will also require that insurers make the directions and details of accessing contraceptive coverage abundantly clear to consumers.
“This rule, once finalized, will expand contraception coverage for 52 million women of reproductive age with private health insurance,” Jennifer Klein, Director of the White House Gender Policy Counsel, told reporters. “For the first time ever, women would be able to obtain over-the-counter contraception without a prescription at no additional cost, and health plans would have to cover even more prescribed contraceptives without cost sharing.”
President Joe Biden issued an executive order in June 2023, the year anniversary of overturning Roe, to expand access to contraceptives by instructing various administrative departments to consider new guidance that would “streamline the process for obtaining care women need and want.”
That order, among other things, expanded contraceptive coverage affordability under Obamacare plans and increased family planning services through clinics funded under Title X for low-income individuals.
Monday’s announcement comes at an opportune time for Democrats in the election cycle, as Vice President Kamala Harris has made reproductive rights a centerpiece of her campaign.
Christine Lucius, domestic policy advisor for Harris, told reporters that the vice president “has been clear” about her stance on improving access to contraception.
“Every person in America should have the freedom to access the healthcare they need,” said Lucius. “To that extent, we have been working towards this major announcement for some time as we continue our work to lower drug prices and advance access to healthcare.”
Democrats up and down the ticket have emphasized access to abortion in their campaign strategy, after they received substantial electoral victories in 2022 and 2023 in the immediate aftermath of overturning Roe.
Although former President Donald Trump has tried to move the Republican position on abortion to the middle, saying that abortion policy should be left to the states, Democrats have continued to advocate abortion protections at the federal level.
“Republican elected officials continue to threaten women’s health, lives, and freedom through extreme abortion bans, some with no exceptions for rape or incest,” reads White House documents on the proposed rule.
Since June 2022, 25 states have passed gestational age limits for abortion. Fertility treatments, including in vitro fertilization, or IVF, have also come into question in states with states that have enacted fetal personhood laws.
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“Abortion, contraception, and IVF are under attack, while Republicans in Congress refuse to protect nationwide access to this vital reproductive healthcare,” read the documents from the White House. “This extreme agenda is out-of-touch with the American people–which is why voters have overwhelmingly chosen to protect reproductive freedom in every state where abortion has been on the ballot.”
Administration officials told reporters that the rule would be submitted for a 60 day comment period before it could take effect, with the rule likely being implemented for insurance plans somewhere in 2025.
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