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Restore ACA’s contraception mandate

Promise Broken

The Promise

Made on: January 18, 2021
Promise Group: Biden Promise Tracker
Promiser: Joe Biden
Ruling: Promise Broken

"Restore the Affordable Care Act’s contraception mandate in place before the U.S. Supreme Court’s Hobby Lobby decision. … Biden will restore the Obama-Biden policy that existed before the Hobby Lobby ruling: providing an exemption for houses of worship and an accommodation for nonprofit organizations with religious missions. The accommodation will allow women at these organizations to access contraceptive coverage, not through their employer-provided plan, but instead through their insurance company or a third-party administrator."

Promiser:

Joe Biden

Promise Group:

Biden Promise Tracker

Current Status

Last updated: January 8, 2025
Promise Broken
Obama promised, but didn't deliver.

Updates

3 updates
January 8, 2025

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.

June 17, 2024

Biden introduces proposal to restore ACA contraception mandate

The Biden administration is proposing a key step to improve contraception access under the Affordable Care Act, as reproductive rights are a pressing political issue. 

It proposed a rule on Jan. 30, 2023, that would not allow employers to opt out of providing contraceptive coverage for "moral reasons."

The Affordable Care Act — which covers roughly 45 million Americans — guarantees contraceptive coverage for women in group or individual health insurance plans. 

But a Trump-era policy gave employers the option to refuse birth control coverage within their employees' health insurance for moral or religious reasons. Biden campaigned on a promise to reverse this policy and restore the birth control coverage mandate. 

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

The Department of Health and Human Services is still working to finalize the agreement and, according to the Office of Management and Budget, the timetable for the rule to be issued starts in August 2024

The Biden administration also published an executive order in June 2023 ordering the secretaries of labor, treasury and health and human services to further protect access to contraception, along with promoting emergency and over-the-counter birth control. 

Right to Contraception Act

Justice Clarence Thomas' concurring opinion in the Dobbs v. Jackson case, which ruled against abortion as a federal right, suggested that the U.S. Supreme Court could revisit cases including Griswold v. Connecticut, which deemed state bans on contraception unconstitutional. This led Senate Democrats to consider codifying birth control protection into federal law. 

The Senate on June 7 failed to reach the 60-vote threshold to pass the Right to Contraception Act, with every Republican except Susan Collins of Maine and Lisa Murkowski of Alaska voting against the measure. 

Although contraception is legal in all 50 states, the bill would have given federal protection to birth control rights. The bill only focused on the right to contraception, and not coverage under the Affordable Care Act. 

Senate Republicans claim that the legislation is unnecessary because there is no active ban in states or a threat to overturn Griswold. Some politicians have also called the bill a "messaging" stunt ahead of the election. 

Our ruling

We will check on Biden's progress if the final rule goes into effect, but for now we continue to rate this promise In The Works.

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January 6, 2022

Administration signals new proposed rule on contraception in 2022

During the 2020 presidential campaign, Joe Biden promised to overturn restrictions on contraception enacted in 2018 under then-President Donald Trump.

The Trump-era rule change made it easier for employers to deny coverage of certain types of contraception in their employees' health insurance plans. Previously, the law allowed houses of worship to choose not to cover such services in their insurance plans. The Trump-era rule expanded this option to deny coverage to any entity exercising a religious or moral exemption, rather than just houses of worship.

The Biden administration hasn't overturned this rule yet, but it has gone on record saying that it will initiate that process in 2022.

Three departments — Health and Human Services, Labor, and the Treasury — released a joint memo about this provision on Aug. 16, 2021.

The departments "intend to initiate rulemaking within six months," the memo said.

A listing by the Office of Management and Budget pegs February 2022 as the estimated date when the rulemaking process will begin. 

Because official reconsideration of the Trump-era rule is on the calendar for early 2022, we rate this promise In the Works.