New Federal Changes Would Allow Greater Access to OTC Contraceptives at Low or No Cost

Millions of people with private health insurance would be able to pick up over-the-counter methods like condoms, the “morning after” pill and birth control pills for free under a new rule the White House proposed this week.

Right now, health insurers must cover the cost of prescribed contraception, including prescription birth control or even condoms that doctors have issued a prescription for. But the new rule would expand that coverage, allowing millions to buy condoms, birth control pills, or “morning after” pills from local storefronts for free without a prescription.

Meanwhile, Democratic Rep. Mike Levin said this week that Republicans in Congress and others proclaiming to be “pro-choice” are being disingenuous by refusing to support legislation that would protect access to health care, such as the Right to Contraception Act, which he co-sponsored.

“You cannot be ‘pro-choice’ if you’re fine with an extreme Supreme Court undermining Roe v. Wade,” Levin said.

“You cannot be ‘pro-choice’ when you believe all states should have the right to ban all reproductive care. You cannot be ‘pro-choice’ if you’re okay with 44% of women in this country having their reproductive rights stripped away.”

Under the new proposed rule, emergency contraceptives that people on private insurance would be able to access without costs include levonorgestrel, a pill that needs to be taken immediately after sex to prevent pregnancy and is more commonly known by the brand name Plan B.

Without a doctor’s prescription, women may pay as much as $50 for a pack of the pills. And women who delay buying the medication in order to get a doctor’s prescription might jeopardize the pill’s effectiveness, since it is most likely to prevent a pregnancy within 72 hours after sex.

“The proposed rule… would expand access to birth control at no additional cost for millions of consumers,” said Health and Human Services Secretary Xavier Becerra. “Bottom line: women should have control over their personal health care decisions. And issuers and providers have an obligation to comply with the law.”

If implemented, the new rule would also require insurers to fully bear the cost of the once-a-day Opill, a new over-the-counter birth control pill that the U.S. Food and Drug Administration approved last year. A one-month supply of the pills costs $20.

Copays prevent some women from purchasing birth control, the American College of Obstetricians and Gynecologists said in a statement that praised the newly proposed rule.

“Birth control is a critical part of so many of our patients’ lives, but the simple truth is that even with insurance coverage, the cost of copays can be prohibitive for many people,” the statement said.

Federal mandates for private health insurance to cover contraceptive care were first introduced with the Affordable Care Act, which required plans to pick up the cost of FDA-approved birth control that had been prescribed by a doctor as a preventative service.

The proposed rule would not affect those on Medicaid, the insurance program for the poorest Americans. States are largely left to design their own rules around Medicaid coverage for contraception, and few cover over-the-counter methods like Plan B or condoms.

America’s Health Insurance Plans, the lobbying group for private health insurers, said Monday it was reviewing the proposal.

“This proposed rule, if finalized, would be the most significant expansion of contraception coverage under the Affordable Care Act since 2012, when contraception was first required to be covered,” said a statement from the White House.

It added that the Biden-Harris Administration is also issuing new guidance to help patients access other preventive services, such as cancer screenings, that must be covered under the Affordable Care Act.

Associated Press contributed to this report.