HHS, DOL, and Treasury Issue Guidance on Birth Control Coverage under ACA

On July 28, the U.S. Department of Health and Human Services (HHS), in conjunction with the Departments of Labor and of the Treasury (Departments), took action to clarify protections for birth control coverage under the Affordable Care Act (ACA). This action follows President Biden’s Executive Order on ensuring access to reproductive healthcare in the wake of the U.S. Supreme Court’s June 24 Dobbs v. Jackson Women’s Health Organization decision overturning Roe v. Wade. Most private health plans are required to provide birth control and family planning counseling at zero cost under the ACA.

A press release on the matter states that “The guidance comes on the heels of HHS’ work to bolster family planning services, including access to emergency contraceptives. According to a report released by HHS, in 2020, 58 million women benefited from the ACA’s preventive services and birth control coverage, which has saved billions of dollars in out-of-pocket spending on contraceptives since the ACA was passed. In response to increasing complaints from women and covered dependents about not receiving this coverage, the Departments issued this guidance to remind plans and issuers of the ACA’s contraceptive coverage requirements and emphasize the Departments’ commitment to enforcement. Today’s announcement is part of a comprehensive effort by the Biden-Harris Administration to protect women’s access to reproductive health care, while reproductive rights are under assault in many states across the country.”

That said, “The ACA guarantees coverage of women’s preventive services, including free birth control and contraceptive counseling, for all individuals and covered dependents with reproductive capacity. This includes, but is not limited to:

• Hormonal methods, like birth control pills and vaginal rings.
• Implanted devices, like intrauterine devices (IUDs).
• Emergency contraception, like Plan B® and ella®.
• Barrier methods, like diaphragms and sponges.
• Patient education and counseling.
• Sterilization procedures.
• Any additional contraceptives approved, granted, or cleared by the FDA.”

HHS Secretary Xavier Becerra was quoted in the release saying that “Under the ACA, you have the right to free birth control—no matter what state you live in. With abortion care under attack, it is critical that we ensure birth control is accessible nationwide, and that employers and insurers follow the law and provide coverage for it with no additional cost. Family planning, one of the greatest public health achievements of the 20th century, is key to better health outcomes. We will do all we can at HHS to protect family planning and all other forms of reproductive healthcare, including abortion care, because it is essential healthcare.”

The new guidance can be accessed here.

This guidance is just one part of the Biden-Harris Administration’s commitment to reproductive healthcare. HHS has taken additional actions following the Supreme Court’s ruling including launching ReproductiveRights.gov, communicating with health insurers that the industry needs to commit to meet their obligations to provide coverage for contraception, issued guidance to patients and providers on federal law and regulations when seeking information on abortion and other reproductive healthcare, issuing guidance to U.S. retail pharmacies on their obligations under federal civil rights laws, and issuing a proposed rule that aims to strengthen the nondiscrimination provision of the