II 

117TH CONGRESS 

2D SESSION S. 4347 

To require group health plans and group or individual health insurance 

coverage to provide coverage for over-the-counter contraceptives. 

IN THE SENATE OF THE UNITED STATES 

MAY 26, 2022 

Mrs. MURRAY (for herself, Ms. HIRONO, Ms. CORTEZ MASTO, Mr. BROWN, 

Ms. BALDWIN, Mr. REED, Mr. SCHATZ, Mr. BLUMENTHAL, Mr. MARKEY, Ms. SMITH, Mr. MENENDEZ, Mr. KAINE, Mr. MERKLEY, Mr. SANDERS, Ms. CANTWELL, Mr. WHITEHOUSE, Mrs. GILLIBRAND, Mr. HEINRICH, Ms. KLOBUCHAR, Mr. WYDEN, Ms. STABENOW, Mr. BOOKER, Ms. 

ROSEN, Ms. WARREN, Mrs. SHAHEEN, Ms. DUCKWORTH, Ms. HASSAN, 

Mr. BENNET, and Mrs. FEINSTEIN) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

A BILL 

To require group health plans and group or individual health 

insurance coverage to provide coverage for over-thecounter contraceptives. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Affordability is Access 

5 Act’’. 


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1 SEC. 2. PURPOSE. 

2 The purpose of this Act is to ensure timely access 

3 to affordable birth control by requiring coverage without 

4 cost-sharing for oral birth control for routine, daily use 

5 that is approved by, or otherwise legally marketed under 

6 regulation by, the Food and Drug Administration for use 

7 without a prescription. 

8 SEC. 3. FINDINGS. 

9 The Senate finds the following: 

10 (1) Birth control is critical health care that al11 most all women will use at some point in their life12 times. 

13 (2) Access to the full range of reproductive 

14 health care, including birth control coverage as guar15 anteed under Federal law, provides people with the 

16 opportunity to lead healthy lives and get the care 

17 they need to reach their goals. 

18 (3) Family planning has well-documented 

19 health benefits for women, newborns, families, and 

20 communities and can lower the risk of harm to ma21 ternal and infant health. 

22 (4) An estimated 72,000,000 women of repro23 ductive age (ages 15 through 44) live in the United 

24 States, of which nearly 70 percent are at risk of 

25 having an unintended pregnancy. Sixty-five percent 

26 of women of reproductive age are using a contracepVerDate Sep 11 2014 00:27 Jun 04, 2022 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4347.IS S4347

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1 tive method and 12 percent of women at risk for un2 intended pregnancy are not using contraception. The 

3 rates of non-use of contraception are highest among 

4 those between 15 and 19 years old. 

5 (5) The birth control benefit enacted under the 

6 Patient Protection and Affordable Care Act (Public 

7 Law 111–148) has been a crucial step forward in 

8 advancing access to birth control and has helped en9 sure 62,100,000 women have the power to decide for 

10 themselves if and when to start a family. 

11 (6) Despite legal requirements for birth control 

12 coverage and access to services, gaps remain for mil13 lions of people. A national survey found that 1 in 3 

14 women have struggled to afford birth control at 

15 some point in their lives, and as a result, have used 

16 birth control inconsistently. Access to birth control is 

17 particularly difficult for people who live in contra18 ceptive deserts and lack reasonable access to a 

19 health center that offers the full range of contracep20 tive methods. 

21 (7) Health disparities persist among people 

22 with low incomes, people of color, LGBTQ people, 

23 immigrants, and people who lack access to health 

24 coverage and health care providers. 


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1 (8) There are numerous social and economic 

2 barriers that make it harder to access birth control, 

3 including rising income and wealth inequality, gaps 

4 in insurance coverage and challenges accessing 

5 health providers. 

6 (9) Leading health experts support over-the7 counter birth control pills. 

8 SEC. 4. SENSE OF THE SENATE. 

9 It is the sense of the Senate that— 

10 (1) in order to increase access to oral birth con11 trol, such birth control must be both easier to obtain 

12 and affordable and, to make such birth control ei13 ther easier to obtain or more affordable, but not 

14 both, is to leave unacceptable barriers in place; 

15 (2) it is imperative that the entities that re16 search and develop oral birth control and whose 

17 medical and scientific experts have developed clinical 

18 and other evidence that oral birth control for rou19 tine, daily use is safe and effective when sold with20 out a prescription, apply to the Food and Drug Ad21 ministration for review and approval for sale of such 

22 birth control without a prescription; 

23 (3) upon the receipt of such an application, the 

24 Food and Drug Administration should determine 

25 whether the oral birth control meets the rigorous 


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1 safety, efficacy, and quality standards for over-the2 counter use under the Federal Food, Drug, and Cos3 metic Act (21 U.S.C. 301 et seq.), and if the prod4 uct meets those standards, the Food and Drug Ad5 ministration should approve the application without 

6 delay; and 

7 (4) if and when the Food and Drug Adminis8 tration approves an oral birth control that is avail9 able over-the-counter, such birth control should be 

10 covered by health insurance, without a prescription 

11 and without cost-sharing. 

12 SEC. 5. CLARIFYING COVERAGE REQUIREMENTS. 

13 The Secretaries of Health and Human Services, 

14 Labor, and the Treasury shall clarify that coverage of con15 traceptives pursuant to section 2713(a)(4) of the Public 

16 Health Service Act (42 U.S.C. 300gg–13(a)(4)) includes 

17 coverage of over-the-counter contraceptive methods ap18 proved by the Food and Drug Administration, even if the 

19 enrollee does not have a prescription for the contraceptive. 

20 SEC. 6. RULES OF CONSTRUCTION. 

21 (a) NON-INTERFERENCE WITH FDA REGULA22 TION.—Nothing in this Act shall be construed to modify 

23 or interfere with Food and Drug Administration processes 

24 to review or approve, or otherwise determine the safety 

25 and efficacy of, and make available, non-prescription 


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1 drugs or devices, modify or interfere with the scientific 

2 and medical considerations of the Food and Drug Admin3 istration, or alter any other authority of the Food and 

4 Drug Administration. 

5 (b) NON-PREEMPTION.—Nothing in this Act pre6 empts any provision of Federal or State law to the extent 

7 that such Federal or State law provides protections for 

8 consumers that are greater than the protections provided 

9 for in this Act. 

10 SEC. 7. DUTIES OF RETAILERS TO ENSURE ACCESS TO 

11 ORAL BIRTH CONTROL FOR USE WITHOUT A 

12 PRESCRIPTION. 

13 (a) IN GENERAL.—Any retailer that stocks oral birth 

14 control for routine, daily use that is approved by, or other15 wise legally marketed under regulation by, the Food and 

16 Drug Administration for use without a prescription may 

17 not interfere with an individual’s access to or purchase 

18 of such birth control or access to medically accurate, com19 prehensive information about such birth control. 

20 (b) LIMITATION.—Nothing in this section shall pro21 hibit a retailer that stocks oral birth control for routine, 

22 daily use from refusing to provide an individual with such 

23 oral birth control that is approved by, or otherwise legally 

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1 istration if the individual is unable to pay for the birth 

2 control, directly or through insurance coverage. 

Æ 


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