The Roadmap to Affordable Contraception
Momentum is building toward true affordability for over-the-counter (OTC) contraception! This short video simplifies the complex process behind truly affordable OTC access to the birth control pill. CAI co-founder Dana Singiser, the author of the Roadmap to Affordability, narrates the video.
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Read here about the groundbreaking Biden-Harris proposed rule on private insurance coverage for over-the-counter contraception!
In a major step forward toward affordability, on Oct. 21, 2024, the federal government released proposed regulations that — if finalized and implemented — would significantly enhance the Affordable Care Act’s contraceptive coverage requirement, including by requiring most U.S. health plans to cover over-the-counter (OTC) contraceptives without cost-sharing and without a prescription. Many of the ideas that CAI proposed as part of our comments to last year's Request for Information were included in the proposed rule. This would be a major advancement over current federal guidance, which says plans must cover OTC contraceptives but may require a medically unnecessary prescription as a condition of coverage — a condition that undermines the benefits of OTC access. The proposed regulations would also require plans to provide information to enrollees about this new benefit and how to access it. Public comments on the proposal will be due in late December, after which the government must review those comments and finalize the regulations.
This groundbreaking CAI report quantifies, for the first time, the impact of expanding contraceptive insurance coverage to over-the-counter products. An additional 56.8 million women of childbearing age would gain coverage of the birth control pill with no copay. The report is co-authored by leading experts Adam Sonfield and Dana Singiser.
Resources
See additional content from CAI’s White Paper on OTC Contraceptive Coverage here.
Read “Accessible Consumer Choices: Shaping the Future of Contraceptive Care at Pharmacies,” a report from the American Pharmacists Association (APhA) and CAI published in September 2024.
On Feb. 28, 2024, APhA and the CAI co-convened a summit to identify barriers and solutions in creating accessible pathways for consumers to receive contraception. Colleagues from across public and private sectors came together to collaboratively address challenges that both pharmacists and consumers face in improving contraceptive access. Through panels, discussions and working groups, participants identified solutions relating to four larger groupings of possible barriers: pharmacy and retail store operations, health plans, the pharmacy profession and public policy and advocacy.
A post-conference survey and analysis revealed a total of 18 broadly supported recommendations included in this report; the top five rated based on feasibility and impact are marked in the attached report’s summary. The recommendations should be used to guide policymakers, patient advocacy groups and pharmacies/pharmacy organizations on making changes and establishing partnerships to assure and increase access to affordable contraceptive care at the pharmacy.
Find further information on the following federal programs, below: