New data released on LawAtlas.org by Elizabeth A. McCaman, JD, MPH, a senior attorney at the National Health Law Program, captures insurance coverage mandates of contraception in all 50 U.S. states and the District of Columbia in effect from January 1, 2016 through December 31, 2021.
The dataset finds:
- Seven jurisdictions curtail medical management in private insurance, but only California extends that restriction to Medicaid enrollees.
- Nine jurisdictions require all contraceptives be covered without cost-sharing in private insurance unless there is a therapeutic equivalent; only DC’s law extends to Medicaid enrollees.
- Sixteen jurisdictions require coverage of over-the-counter contraceptives, such as condoms, spermicide, or Plan B. Of those 16, five explicitly require a prescription for coverage, while the eleven remaining do not.
- All 21 jurisdictions require coverage of an extended supply of contraceptives, although exceptions apply in seven states.
- Vasectomy coverage is not mandated in any state Medicaid programs
Contraception plays a pivotal role in the well-being and health of people worldwide and allows individuals to reduce unintended pregnancies and safely space their pregnancies. Because of the Affordable Care Act (ACA), approximately 64.3 million women now have coverage of birth control without out-of-pocket costs. Recognizing additional gaps in access after finalization of the ACA’s preventive services guidance, 21 states have enacted their own laws that expand beyond the federal contraceptive coverage requirements.
The scope of contraceptive coverage laws varies by state, but may apply to both private and public health insurance programs. These laws generally expand the range of contraceptive methods and services that are covered without cost-sharing, and limit insurer practices of medical management, such as prior authorization or step therapy, which create barriers to access.
Access this dataset and others on reproductive rights on LawAtlas.org.