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Birth Control Coverage

would be harder to get — and would not be guaranteed under the ACA — if rules from the Trump administration took effect



Learn all about birth control access in America, including when it was legalized and how it’s being restricted

Why It Matters

  • The Trump administration issued rules designed to end the Affordable Care Act’s (ACA) contraception mandate, which guarantees no-copay birth control coverage in the country’s insurance plans.

  • Federal courts halted the rules. But if the rules had gone into effect, they would have allowed virtually any employer or school deny birth control coverage to workers and students.

  • Nearly 63 million women now have access to birth control without copayments thanks to the ACA’s birth control mandate. The Trump administration's birth control rules threaten to reverse those gains.

Related Players

Donald Trump

President of the United States

Elected to Office: 11-8-2016
Mike Pence

Vice President of the United States

Elected to Office: 11-8-2016
Diane Foley

Deputy Assistant Secretary for Population Affairs (HHS)

Appointed: 5-29-2018
Valerie Huber

Senior Policy Advisor at the Office of Global Affairs; Former Senior Policy Advisor for the Assistant Secretary for Health (HHS)

Appointed: 6-6-2017
Katy Talento

Former Special Assistant to the President, White House Domestic Policy Council

Resigned: 6-1-2019
Alex Azar

Secretary of Health and Human Services (HHS)

Nominated by Trump: 11-13-2017
Matthew Bowman

Principal Advisor at the Office of Civil Rights, Former Deputy General Counsel (HHS)

Appointed to HHS: March 2017
Steven Valentine

Chief of Staff for the Assistant Secretary of Health (HHS)

Appointed to HHS: Early 2017
Randy Pate

Former Director of the Center for Consumer Information and Insurance Oversight (HHS)

Appointed By Secretary of Health: April 2017


  • 11-7-2018 
    Rules finalized to let employers, universities refuse to cover birth control
  • 10-06-2017
    Administration tries to roll back ACA’s no-copay birth control guarantee

  • 1-5-2017
    Anti-birth control activist Katy Talento becomes key health policy adviser

“As a woman in my mid-twenties, having access to birth control means that I can focus on getting my Masters and starting my career, so that I can give back to my community and support my family — when I'm ready to have one.”

Birth Control is Used by 9 in 10 Sexually Active Women

Without insurance, an IUD could cost more than $1,300 out-of-pocket, and birth control pills could cost up to $600 per year. For women with low incomes, birth control costs like those can mean the difference between getting groceries, gas, or other necessities for month by month. Nationwide, the ACA’s birth control benefit saved women an estimated $1.4 billion on birth control pills the first year (2013) that the law was in effect. So, when the Trump administration issued rules to take away the guarantee of no-copay coverage — it faced a flood of resistance from women's health advocates and courts.

Taking away birth control coverage would make it harder for millions of people to get the care they need. Forty percent of Black women ages 18-44 say they couldn’t afford more than $10 a month for birth control if they had to pay out of pocket. Research shows that when people have access to birth control, they can take better care of themselves or their families, support themselves financially, complete their education, and advance in their careers.

Background on Birth Control Coverage

What the Birth Control Rules Would Do to Coverage

The final version of the birth control rules would make it easier for employers to opt out of the ACA’s requirement to provide birth control coverage in their employer-sponsored insurance plans.

75% of Privately Insured Women Got Birth Control Coverage

Thanks to the ACA’s birth control mandate, three-fourths of women with private health insurance now have access to no-copay birth control coverage.

Kaiser Family Foundation
Mounting Lawsuits Against Birth Control Coverage Opt-Outs

In November 2018, the administration finalized its birth control rules, making minor changes to try and work around mounting lawsuits from state attorneys general and reproductive rights advocates.

Decreasing Unintended Pregnancies

Birth control access has helped bring unintended pregnancy to a 30-year low and teen pregnancy to an all-time low.

Huffington Post
Majority Of Americans Support No-Copay Birth Control

Nearly three-fourths of Americans — 71% — support the ACA’s birth control coverage benefit.

PerryUndem, via Vox
Temporarily Stopping the Rules from Taking Away No-Copay Birth Control Coverage

The day the Trump administration’s birth control rules were set to go into effect, a federal judge in Pennsylvania put a nationwide hold on them. The judge’s decision said the rules would cause many people to lose contraceptive coverage, and that would result in more unintended pregnancies and more reliance on state-funded contraception services. The court ruling helped ensure (at least temporarily) that the nearly 63 million women who now have access to birth control without copayments thanks to the ACA can keep it.

Many Women Can’t Afford to Pay for Birth Control Out of Pocket

Before the ACA, one in three women voters struggled to afford prescription birth control. And less than 40% of Black women can afford $10 per month out of pocket.

Planned Parenthood

Related Policies

The Title X Gag Rule

The Health Agenda

Refusal Policies

Sex Education