Administration Moves to Expand Birth Control Coverage Under ACA

WASHINGTON — Women whose employers opted out of covering contraceptives under their health insurance plans on religious grounds could regain no-cost access to birth control under new rules proposed by the Biden administration.

If implemented, the rules, which were announced under the auspices of the Departments of Health and Human Services, Labor and Treasury, would roll back a Trump-era regulation that allows employers with moral objections to block insurance coverage to birth control, while leaving in place the religious exemption.

According to a press release on the Centers for Medicare & Medicaid Services website, the proposed rules would create an independent pathway for women enrolled in such plans to make their own choice to access contraceptive services directly through a willing contraceptive provider. 

“Now more than ever, access to and coverage of birth control is critical as the Biden-Harris administration works to help ensure women everywhere can get the contraception they need, when they need it, and — thanks to the ACA — with no out-of-pocket cost,” said HHS Secretary Xavier Becerra in a written statement on Monday. 

“Today’s proposed rule works to ensure that the tens of millions of women across the country who have and will benefit from the ACA will be protected. It says to women across the country, we have your back,” he said.

The Affordable Care Act requires private insurance plans to cover recommended preventive services including contraception without any patient cost-sharing, but a change to the regulations in 2018 expanded exemptions for religious beliefs and moral convictions allowing private health plans and insurers to exclude coverage of contraceptive services. 

The 2018 rules included an optional accommodation that allows objecting employers and private colleges and universities to completely remove 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 elected the accommodation — leaving many without access to no-cost contraceptives. 

According to administration officials, the U.S. Supreme Court’s decision last summer in Dobbs v. Jackson Women’s Health Organization, holding that women do not have a constitutional right to abortion, placed a heightened importance on access to contraceptive services nationwide. 

Since then, a number of states have sought to restrict access to contraception, as well as abortion. In response the administration has stepped up its efforts to clarify protections for birth control coverage under the ACA.

Those wishing to review or comment on the proposed rules during their 60-day public comment period should visit the Federal Register here. The rule is expected to be published in the Federal Register on Feb. 2.

Dan can be reached at [email protected] and @DanMcCue