Biden to Sign Executive Order to Expand Contraception Access

WASHINGTON — President Biden will sign an executive order Friday aimed at making it easier for women to access contraception.

“This will be the third executive order on reproductive healthcare access that the President has signed since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, and the first focused specifically on protecting and expanding access to contraception,” Jen Klein, assistant to the president and director of the White House Gender Policy Council, said on a Zoom call with reporters Thursday afternoon. Klein was referring the high court decision that overturned Roe v. Wade, the 1973 Supreme Court decision that legalized abortion nationwide.

“President Biden and Vice President Harris believe that contraception is an essential component of reproductive healthcare, and that women should have access to the contraception that they need,” Klein said.

Under the executive order:

• The secretaries of the Treasury, Labor, and Health and Human Services (HHS) must consider new guidance to ensure that private health insurance under the Affordable Care Act covers all FDA-approved contraceptives without cost-sharing.
• The secretaries of the Treasury, Labor, and HHS must consider new actions to improve access to affordable over-the-counter contraception, including emergency contraception. “These actions could include convening pharmacies, employers, and insurers to discuss opportunities to expand access to affordable over-the-counter-contraception; identifying promising practices regarding the coverage of over-the-counter contraception at no cost to patients; and providing guidance to support seamless coverage of over-the-counter contraception,” according to a White House fact sheet.
• The HHS secretary must explore new ways to expand access to affordable family planning services and supplies across the Medicaid program — such as sharing best practices for state Medicaid programs on providing family planning services and supplies, including through Medicaid managed care.
• The HHS secretary also must consider new actions to strengthen the coverage of contraception through Medicare Advantage and Medicare Part D plans. “This action will help ensure that Medicare beneficiaries, especially women of reproductive age with disabilities, can access contraception without unnecessary barriers,” the fact sheet noted.
• The Secretary of Defense, the Secretary of Veterans Affairs, and the Director of the Office of Personnel Management must consider new actions to ensure good coverage of contraception for service members, veterans, and federal employees, and make sure they and their families understand how to access these benefits.
• The HHS secretary must consider ways to encourage federally supported entities — including Title X family planning clinics, community health centers, and the Indian Health Service — to expand the availability and quality of contraception access for those they serve.

The executive order is part of the administration’s three-pronged strategy on reproductive rights, Klein said on the call. “The first is to fight to pass federal legislation to restore the protections that were lost when Roe v. Wade was overturned,” she said. “The second is to work with states, which we’ve been doing all year; last week we had an in-person meeting with state legislators from 41 different states” to discuss legislation to protect or defend reproductive rights. “And then the third piece is taking whatever action the president can by executive action to protect women’s health.”

The Biden administration remains concerned about what states are doing to bar access to contraception, Klein said. “In states with laws that restrict access to abortion, health clinics that provide contraception and other essential healthcare services have shuttered, eliminating critical points of care,” she said. “And as Republican elected officials in some states are not content with eliminating women’s access to abortion and have already targeted contraception, adopting policies that interfere with access to emergency contraception and threatening to ban or further restrict birth control.”

For example, “some states have interfered with access to emergency contraception including through state family planning programs, and some officials openly talked about and threatened to ban contraception,” Klein told MedPage Today. In Texas, the state “is not paying for any form of emergency contraception for low-income women and girls in their state family planning program. In Iowa, the attorney general has suspended payments for emergency contraception for survivors of sexual assault. That’s just two examples of what we’ve seen.”

The White House also released a report on the effect of the Dobbs decision on abortion access in the states. The report noted that:

• A total of 18 states have abortion bans in effect, and six more states have bans on hold in the courts
• More than 23 million women of reproductive age currently live in states with abortion bans in effect
• Voters in six states passed referendums in 2022 in support of reproductive rights
• Seven new state abortion bans have passed so far in 2023

The presidential action comes on the eve of the first anniversary of the Dobbs decision, which was issued by the Supreme Court on June 24, 2022. To further mark the anniversary, Biden and Harris are both speaking at a reproductive rights event Friday afternoon at a Washington hotel, and Harris is also speaking in North Carolina on Saturday, Klein said.