Promise Broken: Biden proposed rules to expand contraception coverage, but none were finalized

President Joe Biden's administration aimed to give Americans insured under the Affordable Care Act  greater access to contraceptives, but President Joe Biden did not fulfill this promise.

The Affordable Care Act guarantees contraceptive coverage for women in group or individual health insurance plans, but a 2017 policy adopted during President-elect Donald Trump's first term enabled employers to refuse birth control coverage for moral or religious reasons. 

Under a rule proposed in January 2023, the Biden administration would have prohibited employers from opting out of providing contraceptive coverage for "moral reasons." Two years later, the rule remains unapproved.

Under the 2023 rule proposal, houses of worship and religious nonprofits could still exempt themselves from supplying birth control. However, the rule would create an "individual contraceptive arrangement" so their employees could still access contraception through a third-party provider. The objecting organization would not be involved and the birth control would still be covered.

The rule initially had an August 2024 timetable to take effect, but that was pushed back to December 2024. It still hasn't taken effect.

As of January, the Department of Health and Human Services, aided by the Centers for Medicare and Medicaid Services, were still working to finalize the rule.

When asked for more details about the rule's status, a Centers for Medicare and Medicaid Services spokesperson told PolitiFact the agency doesn't speculate on its rulemaking time lines.

The White House separately issued a June 2023 executive order directing the secretaries of labor, treasury and health and human services to further protect contraceptive access, and promote access to emergency and over-the-counter birth control. Those organizations proposed a rule Oct. 21, 2024, addressing the executive order's directives to expand access to contraceptive products, including making over-the-counter contraception free for reproductive-age women who have private health insurance. Under the proposal, health insurance companies, for the first time, would be required to cover recommended over-the-counter birth control products, such as condoms and emergency contraception, without a prescription and at no cost. But that rule also hasn't been finalized.

Biden campaigned on a promise to restore the birth control coverage mandate in the Affordable Care Act. Although his administration made progress to get this approved, it is still not in effect. As such, we rate this Promise Broken.