Is Biden Making Birth Control Free? Yes and No.
Is the Biden administration making birth control free? You may have heard the rumors that the Biden-Harris administration is planning on making over-the-counter birth control free and wondered if the rumors are true. The answer is: yes, but no.
On October 21, 2024, the Biden administration announced that it intends to extend the Affordable Care Act’s coverage of birth control to include over-the-counter birth control, emergency contraception, and a larger variety of birth control methods. In 2012, the Affordable Care Act was expanded to include most forms of birth control. Under the ACA, insurers are required to cover contraception with a prescription. However, newer prescription contraceptives are often not covered, as are more uncommon brands.
Under the October 2024 expansions, birth control coverage will now include newer contraceptives like IUDs and other permanent birth control methods, as well as emergency contraceptives like Plan B. The majority of changes are focused on covering over-the-counter birth control. The FDA approved the first over-the-counter birth control pill, Opill, in July 2023, and it hit the market during the first quarter of 2024. In addition to Opill, over-the-counter birth control as a category also includes condoms, spermicide, and spermicide gels.
The Affordable Care Act will require insurance providers to provide information about contraception coverage in online transparency tools. Additional guidance on HIV prevention and risk reduction medication, reducing charges for preventative care related to women’s health issues, and chest surgeries related to mastectomies were also released through the recent ruling.
However, this will not “make birth control free”. Rather, it will eliminate additional costs that many insurers impose on these more uncommon methods of birth control. The rule hopes to expand access to the approximately 52 million women who receive insurance coverage through private insurance, as well as the millions of women who receive coverage through the Affordable Care Act.
Opill is a progestin-only pill that works by thickening cervical mucus to block sperm. In contrast, the most common form of prescription birth control (the “combination” pill) uses a variety of hormones, including estrogen, to block ovulation. Pills that contain estrogen must be prescribed by a doctor because estrogen increases the risk of blood clots and other similar health risks. Likewise, emergency contraceptives containing ulipristal acetate (such as the morning-after pill Ella) are only available by prescription.
Following the 2022 overturning of Roe v. Wade, the US Supreme Court decision that eliminated or limited access to abortion in many states, contraception began receiving increased public attention. In particular, emergency contraception and male contraception became a focus for many wishing to prevent pregnancy.
On these recent changes, the Centers for Medicare and Medicaid Services administrator Chiquita Brooks-LaSure says, “People with private coverage should know they have coverage of preventive services, including FDA-approved contraception, at no additional cost — full stop. This historic action by the Biden-Harris Administration is vital to ensuring people have control over personal decisions about their health, lives, and families — without facing financial barriers to accessing their birth control method of choice.”