48 Senators Urge Biden Administration To Mandate Coverage of OTC Contraceptives

48 Senators Urge Biden Administration To Mandate Coverage of OTC Contraceptives
48 Senators Urge Biden Administration To Mandate Coverage of OTC Contraceptives


Forty-eight U.S. Senators sent a letter to the Departments of Health and Human Services, Treasury and Labor on Monday, pressing the Biden Administration to require federally and state-regulated health insurance plans to cover over-the-counter contraceptives.

The letter was led by Senators Patty Murray (D-Washington), Tammy Baldwin (D-Wisconsin), Bernie Sanders (I-Vermont) and Ron Wyden (D-Oregon). It comes several months after the Food and Drug Administration approved Opill, the first daily oral contraceptive approved for non-prescription use in the U.S. It will become available in 2024. However, current guidance allows federally and state-regulated private health plans to require patients to get a prescription for over-the-counter contraceptives in order to receive health coverage with no cost-sharing.

“The availability of safe and effective OTC birth control products has enormous potential to help people overcome significant barriers to consistent contraceptive use, including the many logistical and financial challenges to obtaining a prescription,” the senators said. “The FDA’s approval of Opill is a milestone; however, for an OTC birth control pill to meet its potential and be truly accessible, federal departments must ensure that it is covered without cost-sharing and without the need for a prescription as a condition of coverage.”

They also asked for additional steps by the departments, including: 

  • Working with healthcare stakeholders to make sure coverage of over-the-counter contraceptives runs smoothly at pharmacies and via mail order
  • Providing notice to beneficiaries and health stakeholders about changes to coverage, and information on how to “navigate and facilitate” coverage of over-the-counter contraceptives 
  • Providing guidance that encourages state Medicaid programs to cover over-the-counter birth control without a prescription
  • Giving pharmacies, providers and insurers guidance on how to improve claims processing and reimbursement for over-the-counter birth control

Currently, more than 19 million women of reproductive age in the U.S. live in contraceptive deserts, according to Power to Decide, an organization focused on sexual and reproductive health. In addition, about a third of women who have received prescription contraceptives have experienced barriers to accessing birth control, research by KFF shows. The senators noted that “given the increased need for access to contraception in the wake of the Dobbs decision, this issue is incredibly timely and important.” The Dobbs decision took away the constitutional right to abortion.

Dana Singiser, co-founder of the Contraceptive Access Initiative, applauded the senators for the letter. The organization is a nonprofit advocating for improved access to contraception.

It makes no sense to cover contraception when obtained with a prescription, and not cover it without — the enormous health benefits are the same,” Singiser said in a statement. “People should be able to use their insurance coverage for birth control pills whether they get it by prescription from a medical provider or whether they simply purchase it off the shelf at a pharmacy.”

Photo: MikeyLPT, Getty Images



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