Senate Democrats press Biden administration to cover over-the-counter birth control

Senate Democrats are pressing the Biden administration to require health insurance plans to fully cover over-the-counter (OTC) contraceptives.

In a letter to administration officials dated Friday and released Monday, 48 senators asked the departments of Health and Human Services; Labor; and the Treasury to take concrete steps to ensure contraceptives are covered without cost-sharing and without the need for a prescription. 

The letter applauded past executive orders from the White House, including one from June aimed at increasing access to contraception and family planning.

But the senators asked officials to do more, such as issue new guidance for health plans, eliminate any cost-sharing and prior authorization and encourage state Medicaid programs to cover OTC contraceptives without a prescription.

The Affordable Care Act requires insurers to cover preventive services, including specific types of birth control, but only if they are prescribed. Insurers usually don’t cover OTC products.

The first OTC birth control pill was approved by the Food and Drug Administration (FDA) earlier this year. Opill, made by Dublin-based Perrigo, is likely to become available in stores and online starting in early 2024 for women of all ages.

It is more than 90 percent effective at preventing pregnancies, making it more effective than other OTC contraceptives such as condoms or spermicides.

The price of Opill hasn’t been disclosed yet, but studies have shown even a small cost burden can present a significant barrier and make a drug inaccessible. So, barring any policy change, the retail price will determine how easily people can get it.

“The FDA’s approval of Opill is a milestone; however, for an OTC birth control pill to meet its potential and be truly accessible, federal departments must ensure that it is covered without cost-sharing and without the need for a prescription as a condition of coverage,” the senators wrote. 

The push to make birth control available OTC has been happening for years, but after the Supreme Court overturned Roe v. Wade and ended the constitutional right to an abortion, the movement took on more urgency.

“Over 19 million women live in counties with limited access to health care providers that offer comprehensive contraceptive services, and about one-third of women who have received prescription contraceptives have reported barriers to access. Expanding access to affordable coverage for eligible, uninsured populations would improve the quality of contraceptive care that patients receive,” the senators wrote.