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The Biden Administration wants health insurance to cover all OTC contraception

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The Biden administration wants health insurance to cover all over-the-counter contraception. That includes the new birth control pill available without a prescription as well as condoms and Plan B. NPR pharmaceuticals correspondent Sydney Lupkin reports.

SYDNEY LUPKIN, BYLINE: Under the Affordable Care Act, women have been able to get birth control pills for $0 at the pharmacy counter using their health insurance, but that means they've needed to have a prescription from a doctor. Now that the Food and Drug Administration has approved a pill that does not require a prescription, called Opill, the Biden administration wants health insurance to cover that, too. The administration is proposing a new rule under the Affordable Care Act requiring health insurance to provide access to over-the-counter contraception for women without a co-pay. That would include Opill, as well as Plan B and condoms. Here's what Health and Human Services secretary Xavier Becerra said when he announced the proposal.

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XAVIER BECERRA: 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.

LUPKIN: He says services that prevent pregnancy are more important than ever since the Supreme Court overturned Roe v. Wade in 2022. Laurie Soble is the director of women's health policy at the nonprofit think tank KFF. She says a few states have tried to cover over-the-counter contraception like this, but getting the word out was tricky, and people haven't always taken advantage of it.

LAURIE SOBLE: By doing something at the federal level that requires all private health insurance plans to cover over-the-counter contraception without cost sharing, it makes it much easier to message to people and to inform people that this is part of their coverage.

LUPKIN: However, she points out that it seems as though only women can buy condoms using their health insurance without a co-pay under this proposed rule. Still, it's a big deal, she says.

SOBLE: It's definitely a step. It's huge. Condoms have never been covered before.

LUPKIN: The details are still coming into focus. Women could need to buy the products and then get reimbursed, but more likely, they would pick them up in the aisles and buy them at the pharmacy counter, which is typically equipped to handle health insurance. The proposed rule, if it goes through, would likely not take effect until at least 2025, and a new Congress could undo it. Sydney Lupkin, NPR News.

(SOUNDBITE OF LUPE FIASCO SONG, "OUTSIDE") Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Sydney Lupkin
Sydney Lupkin is the pharmaceuticals correspondent for NPR.