CMS proposes rules to expand access to contraception under ACA

The Biden administration has proposed a rule that aims to make it easier for people to access contraceptives even if their insurer or employer has opted not to cover birth control for religious or moral reasons.

In 2018, the Trump White House finalized a rule that allowed private health plans to exclude contraceptive coverage for religious or moral convictions, and the new rules issued Monday would nix the moral exemption while keeping the religious one in place. The original regulations also allowed employers or universities to fully opt out of providing contraceptive coverage while offering a pathway for them to secure birth control at no cost.

However, the employer had to specifically opt in to this alternative, and many did not, which left their workers with no way to access no-cost contraception. Contraceptive coverage is otherwise guaranteed as a preventive service under the Affordable Care Act (ACA).

The new proposed rule would establish an "independent pathway" for these workers to obtain contraception at a participating provider at no cost even if their employer or health plan elects not to cover such services due to religious reasons and chooses not to opt into the alternative accommodation, the Centers for Medicare & Medicaid Services said.

“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," said Department of Health and Human Services Secretary Xavier Becerra. "It says to women across the country, we have your back.”

Access to contraception has been a key focus for the Biden administration since the Supreme Court last summer struck down the national right to abortion in its controversial Dobbs decision. The White House also released updated guidance that seeks to clarify contraceptive protections under the ACA.