There are only a few weeks left until the 2024 presidential election, but President Joe Biden’s administration appears determined to advance one more reproductive rights-related fight before a new president is chosen. On Monday, the White House proposed new rules under the Affordable Care Act that would require insurers to cover over-the-counter birth control without a prescription and without charging patients.
As of now, the ACA ensures that people do not pay a copay or other out-of-pocket costs for prescription birth control when they receive health insurance privately, through their state’s Marketplace, or through most employers. (There are some religious exemptions to the employer mandate.) But birth control pills can cost upwards of hundreds of dollars for those who don’t fit into one of those groups.
The Biden administration’s proposal would cover all over-the-counter contraception products, including condoms, spermicide, and emergency contraception. Many versions of emergency contraception—such as brand-name Plan B One-Step—often cost between $40 and $50, a sum that can represents about full day’s worth of federal minimum-wage work. The over-the-counter birth control pill Opill was only approved by the FDA last year, and so earlier regulations within the ACA did not take it into account.
“This proposed rule will build on the progress we have already made under the Affordable Care Act to help ensure that more women can access the contraceptive services they need without out-of-pocket costs,” Health and Human Services Secretary Xavier Becerra told reporters on Monday, pointing out that the proposal would also require private health insurance providers to notify recipients about the covered over-the-counter products. It’s worth noting that these new rules wouldn’t immediately affect the almost 20% of the U.S. population that is enrolled in Medicaid even if they do come into effect in 2025. But the somewhat sad reality of American politics is that even an initiative that protects only some people’s reproductive autonomy is still a major potential win.