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An Act relative to advancing contraception coverage and economic security in our state 

S 499, H 536

Sponsored by Senator Harriette Chandler and Representatives Pat Haddad and John Scibak


All women should be able to access the preventive care they need

Contraception is basic, preventive health care that every woman should be able to access, regardless of her economic status.  Almost all women, 99% in fact, have used birth control at some point in their lives. 

Contraceptives enable women to plan if and when they want to start a family, have healthier pregnancies, time births, and achieve their desired family size, ultimately improving family stability and the well-being of children. Family planning positively affects more than reproductive health – contraception plays a significant role in helping women and men shape their educational, financial, professional futures, and maintain their emotional well-being.  

Birth control has had such a dramatic positive impact on women and families in this country that the Centers for Disease Control and Prevention (CDC) named it one of the top ten public health achievements of the past century.


Persisting Problems and Future Threats to Access

The Affordable Care Act (ACA) guarantees women access to preventive health care, including birth control, without co-pays. The elimination of out-of-pocket costs has allowed women, regardless of their economic status, to afford basic health care, including the birth control option that works best for them.  With the implementation of the ACA, American women have experienced the single biggest advancement in health care access in a generation.  Right now, over 55 million women in the United States, including 1.4 million women in Massachusetts, have access to preventive services like birth control with zero cost sharing, thanks to the ACA.

This vital access is under serious threat on the federal level, with Republican leadership in Congress vowing to repeal the ACA and eliminate access to birth control with no cost-sharing.  Contrary to claims made by U.S. Health and Human Services (HHS) Secretary, Tom Price, imposing prohibitively expensive co-pays and out-of-pocket expenses will make it extremely difficult for a woman to protect her health and plan her family, especially for women living in our most vulnerable communities.  In fact, this is already the reality for those individuals whose insurance companies – even under the ACA – have used loopholes and onerous cost-saving measures that deny them the full range of birth control options.   

Research conducted by the National Women’s Law Center found many instances of insurance plans failing to comply with the ACA contraceptive-coverage requirement.  For example, it was reported that some insurers were imposing out-of-pocket costs on services associated with birth control, such as a follow up visit to ensure proper placement of an IUD.  Also, some insurers failed to have the necessary processes in place to waive cost-sharing if the specific birth control product prescribed typically has cost-sharing under that plan.


A Proposed Solution

An Act Relative to Advancing Contraception Coverage and Economic Security, sponsored by Senator Harriette Chandler and Representatives Pat Haddad and John Scibak, would protect and expand access to contraceptives by requiring insurers in Massachusetts to cover all FDA-approved contraceptive methods without cost-sharing, including coverage of over-the-counter contraceptives without a prescription.  If passed, this bill will safeguard the 1.4 million Massachusetts women who currently have access to no-copay birth control. 

Even if the ACA birth control benefit remains intact, this bill is an opportunity to build upon the progress of the ACA.  To that end, this legislation will also:

  • Prohibit insurers from using tools like step therapy to undermine and delay access to contraceptives, improving access to basic health care for women who have been denied the promise of the ACA. 
  • Ensure than when a covered contraceptive drug, device, or product is deemed medically inadvisable by a doctor, the insurer will provide coverage for the doctor’s alternatively prescribed birth control.
  • Create equity in contraceptive coverage by eliminating cost-sharing for contraception, voluntary sterilization, and contraceptive counseling for men.  

No woman should be forced to choose between paying out-of-pocket for the birth control that works best for her and accepting medically inadvisable and potentially harmful medication or devices at no-cost.  Decisions regarding birth control methods are best left to doctors and their patients – not their insurance companies.

By passing the An Act Relative to Advancing Contraception Coverage and Economic Security and ensuring every woman has access to the no-cost birth control option that works best for her, Massachusetts can continue to lead the nation in reducing unintended pregnancies and improving health care access.