FOR IMMEDIATE RELEASE
Nov. 19, 2024
Contact: Loretta Kane (917-410-7142 or loretta@caminopr.com)
New report finds governors and state officials ‘blazing a trail’ on making contraception affordable
New stylebook targets increasing contraceptive misinformation/disinformation and politicization of contraceptive policy
WASHINGTON — Today, Contraceptive Access Initiative (CAI) released a new report, “States and contraceptive access: blazing a trail on over-the-counter affordability,” which finds that states are ahead of the federal government in enacting pro-contraceptive access affordability initiatives.
“As the federal government continues its consideration of requiring health plans to cover over-the-counter (OTC) contraceptives, some states are moving ahead with new regulations that offer zero-cost access.,” said CAI co-founder Dana Singiser, who is one of the report’s authors. “States are taking swift action to bridge the gap and enacting models that could guide national policy.”
While the Affordable Care Act (ACA) mandates that prescription contraception be covered without cost-sharing, OTC products — such as Opill, emergency contraception and condoms — currently fall outside this requirement unless a prescription is obtained. This inconsistency has created confusion and barriers to access, despite the fact that the U.S. Food and Drug Administration (FDA) has determined that a prescription is not medically necessary for consumers to use these products safely.
In October 2024, the U.S. Department of Health and Human Services (HHS) proposed new regulations that would require health plans to cover OTC contraceptives without cost-sharing and without a prescription. If enacted, this regulation is expected to take effect in 2026.
In the meantime, governors and state policymakers have not waited for federal action. At least nine states — Arizona, California, Delaware, New Mexico, New York, North Carolina, Pennsylvania, Washington and Wisconsin — have already taken steps to expand access to OTC contraception, often through executive action. Their efforts, including the use of executive orders and policy innovations, are providing valuable lessons for the federal government and other states.
"By covering Opill, emergency contraception and pregnancy tests at no cost for Medicaid recipients, we are removing the financial barriers to reproductive health and ensuring healthcare is accessible and affordable," said Gov. Michelle Lujan Grisham.
Key findings of the report include:
State executive actions lead the way: Governors and state agencies are leveraging executive authority to expand coverage for OTC contraceptives. Arizona Gov. Katie Hobbs, for example, issued an executive order in May 2024 to expand coverage for state employees, Medicaid recipients and private insurance plans, while other states, including California and New Mexico, have used executive action to streamline access for their residents.
Challenges and opportunities for policymakers: State policymakers must navigate complex challenges, including questions of authority, scope and political divisions. In some states, executive orders can bypass legislative barriers, while in others, new laws must be passed to ensure coverage. The report details how states are addressing issues such as pharmacy processes, insurance formularies and consumer education to ensure smooth implementation.
Public education and stakeholder collaboration are key: A major theme of the report is the importance of clear communication and collaboration between state officials, insurers, pharmacies and consumer groups. States like Wisconsin have used high-profile public appearances to maximize awareness, while others, like North Carolina, have partnered with pharmacies to educate Medicaid enrollees about new coverage options.
Preliminary lessons for federal action: The report highlights how states' early efforts are laying the groundwork for federal action, which is expected to culminate in final regulations by 2026. The lessons learned from state actions on OTC contraceptives will be crucial in shaping federal policies that ensure greater access to contraception for all.
“Amid an increasingly hostile federal landscape, states are taking the lead to not only secure but expand access to critical reproductive healthcare, including over-the-counter contraception,” said Reproductive Freedom Alliance Executive Director Christina Chang. “This report showcases how, from standing orders to state-funded Medicaid expansions, Reproductive Freedom Alliance states are working to innovate, test, and implement real solutions that expand access to contraception for millions of residents. Together, Alliance states are stepping up to bridge gaps, address barriers and create a blueprint for accessible, affordable contraception across the country.”
The ongoing efforts by state governments and the federal government’s proposed regulations offer hope that, soon, access to birth control will be universally available without unnecessary barriers, allowing individuals to make decisions about their reproductive health with greater freedom and autonomy.
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The nonprofit Contraceptive Access Initiative advocates for increasing access to contraception, free from stigma, bias and coercion. CAI supports affordable over-the-counter access to oral contraception without restrictions. Our work reduces misinformation and challenges disinformation, while uplifting educational content that helps people make the choices that are right for them.