Biden administration proposes a rule to make over-the-counter birth control free

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In this photo illustration, a package of Opill is displayed on March 22. / Getty Images

The Biden administration is proposing a rule that would expand access to contraceptive products, including making over-the-counter birth control and condoms free for the first time for women of reproductive age who have private health insurance.

Under the proposal by the U.S. Department of Health and Human Services (HHS), Labor Department, and Treasury Department, which was announced by the administration on Monday, health insurance companies would be required to cover all recommended over-the-counter contraception products, such as condoms, spermicide and emergency contraception, without a prescription and at no cost, according to senior administration officials.

It would also require private health insurance providers to notify recipients about the covered over-the-counter products.

The proposed rule comes as the Biden administration seeks to expand access to contraceptives and as other reproductive health, including access to abortion, has become a central issue in the 2024 presidential election campaign. Republican-led states have restricted access to abortion since the Supreme Court overturned Roe v. Wade in 2022. About half of states now ban or severely restrict abortion, which has coincided with steep declines in prescriptions for birth control and emergency contraception in those states.

HHS Secretary Xavier Becerra said when health care insurers impose burdensome administrative or cost sharing requirements for services, “access to contraceptives become even more difficult.”

“We have heard from women who need a specific brand of birth control but the cost of their prescription isn’t covered by their health insurance. We have made clear that in all 50 states the Affordable Care Act guarantees coverage of women’s preventive services without cost sharing, including all birth control methods approved by the Food and Drug Administration,” Becerra told reporters. “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.”

The products would be able to be accessed the same way prescription medicines are accessed, such as at the pharmacy counter, according to senior administration officials. Getting the products through reimbursement would also be an option, depending on the health insurance plan, officials said.

Birth control became available to those with insurance without a copay because of the Affordable Care Act, but that required a prescription.

In July 2023, a daily oral birth control pill, Opill, became the first over-the-counter birth control pill to be approved by the Food and Drug Administration. It became available for purchase online in March and can be purchased for $19.99.

The Biden administration in January announced several actions aimed at strengthening access to abortion and contraceptives, including the Office of Personnel Management issuing guidance to insurers that will expand access to contraception for federal workers, families and retirees.

There will be a comment period on the proposed rule and if approved, it could go into effect in 2025, according to senior administration officials.

However, if former President Donald Trump wins the election, he could reverse the rule.

NPR’s Sydney Lupkin and Bill Chappell contributed to this report.