Photo by Reproductive Health Supplies Coalition
The Biden-Harris administration’s proposed rule to expand access to affordable contraception under the Affordable Care Act (ACA) is a timely and essential move, especially in the current political landscape where reproductive rights have been systematically eroded. This proposal would provide over-the-counter birth control without any cost sharing for women with private insurance, removing significant financial barriers to contraception for millions of women. This would include FDA-approved options such as Opill, the morning-after pill, and other methods like IUDs and condoms. Jennifer Klein, White House Gender Policy Council Director, emphasized that this move could have a transformative impact, ensuring more women can access contraception without cost-sharing.
This initiative couldn’t be more urgent. In the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization—which overturned the nearly 50-year precedent set by Roe v. Wade—the landscape of reproductive healthcare has shifted dramatically. With abortion access now either severely restricted or outright banned in many states, the need for accessible birth control has become a frontline issue. Women who have lost access to safe and legal abortion options are left with limited reproductive choices, making contraception not just a health service but a critical tool of autonomy and control over one’s future. Department of Health and Human Services Secretary Xavier Becerra emphasizes this by saying, “Now more than ever, access to and coverage of birth control is critical as the Biden-Harris administration works to help ensure women everywhere can get the contraception they need when they need it”
The proposed rule would not only strengthen access to prescribed contraceptives but also tackle the loopholes created by religious and moral exemptions that have allowed some employers and institutions to deny birth control coverage. These exemptions have been a contentious issue since 2018, when regulations allowed private health plans to exclude coverage for contraceptive services based on moral or religious objections. Under this new rule, women and dependents enrolled in plans with such exemptions will be able to access contraception directly from willing providers without additional cost, ensuring that their employer’s religious beliefs don’t determine their reproductive choices.
This policy comes at a time when contraception is more than just a personal health decision—it’s a matter of economic and social justice. Nearly 90% of women of reproductive age have used contraception at some point in their lives, and access to reliable birth control is closely tied to women’s ability to pursue higher education, maintain steady employment, and plan their families responsibly. The ability to control if and when to have children is not just a matter of health; it’s a fundamental right that impacts every facet of a woman’s life. As Alexis McGill Johnson, president and CEO of Planned Parenthood, aptly put it, “Access to birth control is critical to reproductive freedom. It gives people the reins to decide their futures.”
However, while this proposal is a positive step, it doesn’t go far enough. The fact that this expanded coverage applies only to those with private insurance leaves millions of women—especially those from low-income backgrounds—still vulnerable. Contraception should not be a luxury afforded only to those employed or enrolled in a university health plan. It should be available, free of charge, to every woman in America, regardless of income, employment status, or geography. Access to birth control shouldn’t depend on a person’s ability to navigate complex insurance systems or rely on an employer’s benevolence.
In addition, this rule still retains religious exemptions for employers, which means that women who work for religious institutions or employers who claim moral objections may still face hurdles. Although the proposal seeks to create independent pathways for these women to access contraception, the process could still impose unnecessary burdens, delaying access to timely contraceptive care. In a country that prides itself on freedom, we should be moving toward a system where reproductive health care is universal, not subject to the whims of individual employers or religious doctrine.
This proposal doesn’t address the needs of women without health insurance. While expanding access to no-cost birth control under the ACA is commendable, those without insurance remain sidelined. The U.S. should be aiming for universal access to contraception—comprehensive coverage that includes everyone, regardless of their insurance status. For a society to truly respect reproductive freedom, it must ensure that contraception is affordable and accessible to all, not just the privileged few.
The Supreme Court’s decision in Dobbs has created a reproductive health crisis in the United States. As state legislatures continue to attack abortion access, the federal government must counterbalance these efforts by protecting and expanding access to contraception. The Biden-Harris administration’s proposal is a necessary first step, but it’s only that—a first step. True reproductive justice will only be achieved when contraception is universally accessible, free from bureaucratic obstacles and moralistic exclusions. Women deserve nothing less.
