Bloomberg Law
Jan. 30, 2023, 5:00 PMUpdated: Jan. 30, 2023, 5:55 PM

Biden Agencies Move to Bolster Access to Birth Control Coverage (1)

Tony Pugh
Tony Pugh

Access to birth control coverage offered under the Affordable Care Act would be expanded and strengthened under a proposed rule issued Monday by the Biden administration.

The ACA guarantees coverage of women’s preventive services, like birth control and contraceptive counseling, at no cost for women enrolled in group health plans or individual health insurance coverage. In 2018, new regulations expanded exemptions for religious beliefs and moral convictions that allow private health plans and insurers to deny coverage of contraceptive services.

Monday’s proposed rule—from the Departments of Health and Human Services (RIN: 0938-AU94), Labor (RIN:1210-AC13), and Treasury (RIN: 1545-BQ35)—would remove the moral exemption and retain the existing religious exemption, the Centers for Medicare & Medicaid Services said in a press statement.

The measure is the latest in a series of steps by the Biden administration to ensure access to reproductive services in the wake of the the US Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization.

In July it issued clarifying guidance for birth control coverage under the ACA following efforts by multiple states to restrict access to contraception. In addition, The HHS, Labor, and the Treasury met with health insurers and called on the industry to meet its obligations to provide contraceptive coverage as required by the ACA.

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 elects the accommodation—leaving many without access to no-cost contraceptives.

The Biden administration proposal would “create a way for individuals enrolled in plans arranged or offered by objecting entities to make their own choice to access contraceptive services directly through a willing contraceptive provider without any cost,” the CMS said in a statement.

“This would allow women and covered dependents to navigate their own care and still obtain birth control at no cost in the event their plan or insurer has a religious exemption and, if eligible, has not elected the optional accommodation.” the agency said. “The proposed rules would leave in place the existing religious exemption for entities and individuals with objections, as well as the optional accommodation for coverage.”

“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,” HHS Secretary Xavier Becerra said in a statement.

The proposed rules reflect the Biden administration’s commitment to ensuring access to reproductive health care, the CMS said.

“If this rule is finalized, individuals who have health plans that would otherwise be subject to the ACA preventive services requirements but have not covered contraceptive services because of a moral or religious objection, would now have access,” CMS Administrator Chiquita Brooks-LaSure said in a statement.

—With assistance from Bloomberg Law Automation

(Updates with additional details throughout. )

To contact the reporter on this story: Tony Pugh in Washington at

To contact the editor responsible for this story: Brent Bierman at