I 
118TH CONGRESS 
1ST SESSION H. R. 3589 
To require group health plans and group or individual health insurance 
coverage to provide coverage for over-the-counter contraceptives. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 22, 2023 
Ms. PRESSLEY (for herself, Ms. OCASIO-CORTEZ, Mr. BERA, Ms. CROCKETT, 
Mr. DOGGETT, Mr. ESPAILLAT, Ms. NORTON, Mr. VARGAS, Ms. 
BROWNLEY, Ms. CASTOR of Florida, Mr. JOHNSON of Georgia, Mr. KIL-
MER, Mrs. NAPOLITANO, Ms. WILSON of Florida, Ms. CHU, Mr. BOW-
MAN, Mrs. WATSON COLEMAN, Mr. POCAN, Mr. BLUMENAUER, Ms. 
BROWN, Ms. MCCOLLUM, Mr. CASTEN, Ms. WILLIAMS of Georgia, Ms. 
CLARKE of New York, Ms. UNDERWOOD, Mr. TRONE, Ms. GARCIA of 
Texas, Mr. KHANNA, Mr. GOMEZ, Mr. EVANS, Ms. SCANLON, Ms. LEE 
of California, Mr. TAKANO, Mrs. MCBATH, Ms. JAYAPAL, Ms. TLAIB, Mr. 
CARTER of Louisiana, Ms. LOIS FRANKEL of Florida, Ms. DELAURO, Ms. 
LEE of Pennsylvania, Mr. CONNOLLY, Mr. PETERS, Mr. CARTWRIGHT, 
Mr. MULLIN, and Mr. MENENDEZ) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committees on Education and the Workforce, and Ways and 
Means, for a period to be subsequently determined by the Speaker, in 
each case for consideration of such provisions as fall within the jurisdic-
tion of the committee concerned 
A BILL 
To require group health plans and group or individual health 
insurance coverage to provide coverage for over-the- 
counter contraceptives. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Affordability is Access 
Act of 2023’’. 
SEC. 2. PURPOSE. 
The purpose of this Act is to ensure timely access 
to affordable birth control by requiring coverage without 
cost-sharing for contraceptives that are approved, granted, 
or cleared by, or otherwise legally marketed under regula-
tion by, the Food and Drug Administration for use with-
out a prescription. 
SEC. 3. FINDINGS. 
Congress finds the following: 
(1) Birth control is critical health care that al-
most all women, as well as many trans men and 
nonbinary people, will use at some point in their life-
times. 
(2) Access to the full range of reproductive 
health care, including birth control coverage as guar-
anteed under Federal law, provides individuals with 
the opportunity to lead healthy lives and get the care 
they need to reach their goals. 
(3) Contraceptive access is associated with 
health benefits for women, newborns, families, and 
communities and can lower the risk of harm to ma-
ternal and infant health. 
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(4) An estimated 73 million women of reproduc-
tive age (ages 15 through 49) live in the United 
States. Among the 46 million of such women who 
are sexually active and not seeking children, 89 per-
cent use a form of birth control. 
(5) The birth control benefit enacted under the 
Patient Protection and Affordable Care Act (Public 
Law 111–148) has been a crucial step forward in 
advancing access to birth control and has helped en-
sure 58 million women have the power to decide for 
themselves if and when to become pregnant. 
(6) Despite legal requirements for birth control 
coverage and access to services, gaps remain for mil-
lions of individuals. Nearly 1 in 5 women are not 
using their preferred method of contraception, and 
of those women, a quarter say it is because of cost. 
As a result, many women have gone without the 
birth control they want to use, also creating incon-
sistent use. Access to birth control is particularly 
difficult for the 19 million women of reproductive 
age with lower incomes who live in contraceptive 
deserts and lack reasonable access to a health center 
that offers the full range of contraceptive methods. 
(7) Due to systemic discrimination, people paid 
low wages, people of color, LGBTQ+ individuals, 
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immigrants, and people with disabilities are more 
likely to face barriers to, and lack access to, health 
coverage and health care providers. 
(8) There are numerous social and economic 
factors that make it harder to access birth control, 
including rising income and wealth inequality, gaps 
in insurance coverage, and barriers to accessing 
health providers. 
(9) Leading health experts support over-the- 
counter birth control pills. 
SEC. 4. SENSE OF CONGRESS. 
It is the sense of Congress that— 
(1) in order to increase access to oral birth con-
trol, such birth control must be both easier to obtain 
and affordable and, to make such birth control ei-
ther easier to obtain or more affordable, but not 
both, is to leave unacceptable barriers in place; 
(2) it is imperative that the entities that re-
search and develop oral birth control and whose 
medical and scientific experts have developed clinical 
and other evidence that oral birth control for rou-
tine, daily use is safe and effective when sold with-
out a prescription, apply to the Food and Drug Ad-
ministration for review and approval for sale of such 
birth control without a prescription; 
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(3) upon the receipt of such an application, the 
Food and Drug Administration should determine 
whether the oral birth control meets the rigorous 
safety, efficacy, and quality standards for over-the- 
counter use under the Federal Food, Drug, and Cos-
metic Act (21 U.S.C. 301 et seq.), and if the prod-
uct meets those standards, the Food and Drug Ad-
ministration should approve the application without 
delay; and 
(4) if and when the Food and Drug Adminis-
tration approves an oral birth control that is avail-
able over-the-counter, such birth control should be 
covered by health insurance, without a prescription 
and without cost-sharing. 
SEC. 5. CLARIFYING COVERAGE REQUIREMENTS. 
The Secretaries of Health and Human Services, 
Labor, and the Treasury shall clarify that coverage of con-
traceptives pursuant to section 2713(a)(4) of the Public 
Health Service Act (42 U.S.C. 300gg–13(a)(4)) includes 
coverage of over-the-counter contraceptives approved, 
granted authorization for emergency use, or cleared by the 
Food and Drug Administration, even if the enrollee does 
not have a prescription for the contraceptive. 
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SEC. 6. RULES OF CONSTRUCTION. 
(a) NON-INTERFERENCE
WITH
FDA REGULA-
TION.—Nothing in this Act shall be construed to modify 
or interfere with Food and Drug Administration processes 
to review, approve, clear, or authorize for emergency use, 
or otherwise determine the safety and efficacy of, and 
make available, non-prescription drugs or devices, modify 
or interfere with the scientific and medical considerations 
of the Food and Drug Administration, or alter any other 
authority of the Food and Drug Administration. 
(b) NON-PREEMPTION.—Nothing in this Act pre-
empts any provision of Federal or State law to the extent 
that such Federal or State law provides protections for 
consumers that are greater than the protections provided 
for in this Act. 
SEC. 7. DUTIES OF RETAILERS TO ENSURE ACCESS TO CON-
TRACEPTION FOR USE WITHOUT A PRESCRIP-
TION. 
(a) IN GENERAL.—Any retailer that stocks contra-
ception that is approved, granted authorization for emer-
gency use, or cleared by, or otherwise legally marketed 
under regulation by, the Food and Drug Administration 
for use without a prescription may not interfere with an 
individual’s access to or purchase of such contraception 
or access to medically accurate, comprehensive informa-
tion about such contraception. 
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(b) LIMITATION.—Nothing in this section shall pro-
hibit a retailer that stocks over-the-counter contraceptive 
products from refusing to provide an individual with such 
contraceptive product that is approved, granted, or cleared 
by, or otherwise legally marketed under regulation by, the 
Food and Drug Administration if the individual is unable 
to pay for the contraceptive product, directly, through in-
surance coverage, or through other payment mechanism. 
Æ 
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