HHS proposes rule to strengthen contraceptive access

HHS proposed a rule Monday that aims to bolster access to birth control coverage under the Affordable Care Act, an issue of “heightened importance,” according to the agency.

The rule would strengthen contraceptive access with the removal of a moral conviction exception to the ACA’s contraceptive mandate and a workaround for religious exemptions, according to a CMS press release.

“We know that access to affordable health care is vital. HHS, along with the Department of Labor and the Department of the Treasury, continues to protect and promote access to the reproductive health care services people need, including contraception,” Chiquita Brooks-LaSure, CMS administrator, said in the release. “If this rule is finalized, individuals who have health plans that would otherwise be subject to the ACA preventive services requirements but have not covered contraceptive services because of a moral or religious objection, would now have access.”

The ACA requires private insurance plans to cover specific preventive services like contraception at no cost. But regulations expanded religious belief and moral convictions exemptions in 2018, a move that allowed private health plans and insurers to exclude contraceptive service coverage, according to the release.

The new proposed rule would leave the religious exemption and its optional accommodation for birth control access in place, but also creates an independent pathway for people under these plans to access contraceptive services directly through a willing provider without any cost.

The pathway, also known as an individual contraceptive arrangement, would not require the involvement of any objecting entity, according to CMS. Any participating facility or provider would be reimbursed.

The proposed rule is open for public comment for the next 60 days and can be submitted here.

Since the Supreme Court ruled 6-3 to uphold the Mississippi law limiting abortion access in the Dobbs v. Jackson Women’s Health Organization case, there has been a “heightened importance on access to contraceptive services nationwide,” according to the release.

“Now more than ever, access to and coverage of birth control is critical,” HHS Secretary Xavier Becerra said in the press release. “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. It says to women across the country, ‘we have your back’.”

References:

• Biden-Harris administration proposes new rules to expand access to birth control coverage under the Affordable Care Act. https://www.cms.gov/newsroom/press-releases/biden-harris-administration-proposes-new-rules-expand-access-birth-control-coverage-under-affordable. Published Jan. 30, 2023. Accessed Jan. 30, 2023.
• Coverage of certain preventive services under the Affordable Care Act: Proposed rules. https://www.cms.gov/newsroom/fact-sheets/coverage-certain-preventive-services-under-affordable-care-act-proposed-rules. Published Jan. 30, 2023. Accessed Jan. 30, 2023.