An Act to Require Health Insurance Coverage for Federally Approved Nonprescription Oral Hormonal Contraceptives (AFTER DEADLINE)
Maine Legislature, Session 131, LD 2203
Committee: Health Coverage, Insurance and Financial Services
Sponsors: ARFORD, DAUGHTRY, CLUCHEY, MILLIKEN, PERRY, SALISBURY, TALBOT ROSS, BAILEY, VITELLI
Amends: 24 MRSA §2332-J, 24-A MRSA §2756, 24-A MRSA §2847-G, 24-A MRSA §4247

Legislative Document
No. 2203
H.P. 1411
House of Representatives, February 1, 2024
An Act to Require Health Insurance Coverage for Federally 
Approved Nonprescription Oral Hormonal Contraceptives
(AFTER DEADLINE)
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
205.
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative ARFORD of Brunswick.
Cosponsored by Senator DAUGHTRY of Cumberland and
Representatives: CLUCHEY of Bowdoinham, LaROCHELLE of Augusta, MILLIKEN of 
Blue Hill, PERRY of Calais, SALISBURY of Westbrook, Speaker TALBOT ROSS of 
Portland, Senators: BAILEY of York, VITELLI of Sagadahoc.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24 MRSA §2332-J, sub-§1, as enacted by PL 1999, c. 341, §1 and affected 
by §5, is amended to read:
1.  Coverage requirements; prescription contraceptives and outpatient 
contraceptive services.  All individual and group nonprofit hospital and medical services 
plan policies and contracts and all nonprofit health care plan policies and contracts that 
provide coverage for prescription drugs or outpatient medical services must provide 
coverage for all prescription contraceptives approved by the federal Food and Drug 
Administration or for outpatient contraceptive services, respectively, to the same extent 
that coverage is provided for other prescription drugs or outpatient medical services.  For 
purposes of this section, the term "outpatient contraceptive services" means consultations, 
examinations, procedures and medical services provided on an outpatient basis and related 
to the use of contraceptive methods to prevent an unintended pregnancy.  This section may 
not be construed to apply to prescription drugs or devices that are designed to terminate a 
pregnancy.
Sec. 2.  24 MRSA §2332-J, sub-§1-A is enacted to read:
1-A.  Coverage requirements; nonprescription oral hormonal contraceptives.  All 
policies and contracts required to provide coverage for prescription contraceptives under 
subsection 1 must provide coverage for nonprescription oral hormonal contraceptives 
approved by the federal Food and Drug Administration to the same extent that coverage is 
provided for prescription contraceptives pursuant to subsection 1.
Sec. 3.  24 MRSA §2332-J, sub-§4, as enacted by PL 2021, c. 609, §1, is amended 
to read:
4.  Coverage of contraceptive supplies.  Coverage required under this section 
subsection 1 must include coverage for contraceptive supplies in accordance with the 
following requirements.  For purposes of this section subsection, "contraceptive supplies" 
means all contraceptive drugs, devices and products approved by the federal Food and Drug 
Administration to prevent an unwanted pregnancy, except "contraceptive supplies" does 
not include nonprescription oral hormonal contraceptives.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a contraceptive supply, an insurer is not required to cover all those 
therapeutically equivalent versions in accordance with this subsection, as long as at 
least one is covered without any deductible, coinsurance, copayment or other cost-
sharing requirement in accordance with this subsection.
C.  Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies intended to last for a 12-month period, which may be furnished 
or dispensed all at once or over the course of the 12 months at the discretion of the 
health care provider.
Sec. 4.  24 MRSA §2332-J, sub-§5 is enacted to read:
5.  Coverage of nonprescription oral hormonal contraceptives.  Coverage required 
under subsection 1-A must include coverage for nonprescription oral hormonal 
contraceptives approved by the federal Food and Drug Administration in accordance with 
the following requirements.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a nonprescription oral hormonal contraceptive, an insurer is not required 
to cover all those therapeutically equivalent versions in accordance with this 
subsection, as long as at least one is covered without any deductible, coinsurance, 
copayment or other cost-sharing requirement in accordance with this subsection.
C.  Coverage must be provided for the furnishing of nonprescription oral hormonal 
contraceptives intended to last for a 12-month period.
A nonprofit hospital or medical service organization or nonprofit health care plan subject 
to this subsection shall establish mechanisms to ensure that an enrollee who purchases a 
nonprescription oral hormonal contraceptive has the option either to make the purchase at 
a pharmacy without a payment required at the point of sale or to make the purchase with a 
payment at the point of sale and submit a claim for reimbursement to the nonprofit hospital 
or medical service organization or nonprofit health care plan.
Sec. 5.  24-A MRSA §2756, sub-§1, as enacted by PL 1999, c. 341, §2 and affected 
by §5, is amended to read:
1.  Coverage requirements; prescription contraceptives and outpatient 
contraceptive services.  All individual health policies and contracts, except accidental 
injury, specified disease, hospital indemnity, Medicare supplement, disability income, 
long-term care and other limited benefit health insurance policies and contracts, that 
provide coverage for prescription drugs or outpatient medical services must provide 
coverage for all prescription contraceptives approved by the federal Food and Drug 
Administration or for outpatient contraceptive services, respectively, to the same extent 
that coverage is provided for other prescription drugs or outpatient medical services.  For 
purposes of this section, the term "outpatient contraceptive services" means consultations, 
examinations, procedures and medical services provided on an outpatient basis and related 
to the use of contraceptive methods to prevent an unintended pregnancy.  This section may 
not be construed to apply to prescription drugs or devices that are designed to terminate a 
pregnancy.
Sec. 6.  24-A MRSA §2756, sub-§1-A is enacted to read:
1-A.  Coverage requirements; nonprescription oral hormonal contraceptives.  All 
policies and contracts required to provide coverage for prescription contraceptives under 
subsection 1 must provide coverage for nonprescription oral hormonal contraceptives 
approved by the federal Food and Drug Administration to the same extent that coverage is 
provided for prescription contraceptives pursuant to subsection 1.
Sec. 7.  24-A MRSA §2756, sub-§3, as amended by PL 2021, c. 609, §2, is further 
amended to read:
3.  Coverage of contraceptive supplies.  Coverage required under this section 
subsection 1 must include coverage for contraceptive supplies in accordance with the 
following requirements.  For purposes of this section subsection, "contraceptive supplies" 
means all contraceptive drugs, devices and products approved by the federal Food and Drug 
Administration to prevent an unwanted pregnancy, except "contraceptive supplies" does 
not include nonprescription oral hormonal contraceptives.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a contraceptive supply, an insurer is not required to cover all those 
therapeutically equivalent versions in accordance with this subsection, as long as at 
least one is covered without any deductible, coinsurance, copayment or other cost-
sharing requirement in accordance with this subsection.
D.  Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies intended to last for a 12-month period, which may be furnished 
or dispensed all at once or over the course of the 12 months at the discretion of the 
health care provider.
Sec. 8.  24-A MRSA §2756, sub-§4 is enacted to read:
4.  Coverage of nonprescription oral hormonal contraceptives.  Coverage required 
under subsection 1-A must include coverage for nonprescription oral hormonal 
contraceptives approved by the federal Food and Drug Administration in accordance with 
the following requirements.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a nonprescription oral hormonal contraceptive, an insurer is not required 
to cover all those therapeutically equivalent versions in accordance with this 
subsection, as long as at least one is covered without any deductible, coinsurance, 
copayment or other cost-sharing requirement in accordance with this subsection.
C.  Coverage must be provided for the furnishing of nonprescription oral hormonal 
contraceptives intended to last for a 12-month period.
An insurer subject to this subsection shall establish mechanisms to ensure that an enrollee 
who purchases a nonprescription oral hormonal contraceptive has the option either to make 
the purchase at a pharmacy without a payment required at the point of sale or to make the 
purchase with a payment at the point of sale and submit a claim for reimbursement to the 
insurer.
Sec. 9.  24-A MRSA §2847-G, sub-§1, as enacted by PL 1999, c. 341, §3 and 
affected by §5, is amended to read:
1.  Coverage requirements; prescription contraceptives and outpatient 
contraceptive services.  All group insurance policies and contracts, except accidental 
injury, specified disease, hospital indemnity, Medicare supplement, disability income, 
long-term care and other limited benefit health insurance policies and contracts that provide 
coverage for prescription drugs or outpatient medical services must provide coverage for 
all prescription contraceptives approved by the federal Food and Drug Administration or 
for outpatient contraceptive services, respectively, to the same extent that coverage is 
provided for other prescription drugs or outpatient medical services.  For purposes of this 
section, the term "outpatient contraceptive services" means consultations, examinations, 
procedures and medical services provided on an outpatient basis and related to the use of 
contraceptive methods to prevent an unintended pregnancy.  This section may not be 
construed to apply to prescription drugs or devices that are designed to terminate a 
pregnancy.
Sec. 10.  24-A MRSA §2847-G, sub-§1-A is enacted to read:
1-A.  Coverage requirements; nonprescription oral hormonal contraceptives.  All 
policies and contracts required to provide coverage for prescription contraceptives under 
subsection 1 must provide coverage for nonprescription oral hormonal contraceptives 
approved by the federal Food and Drug Administration to the same extent that coverage is 
provided for prescription contraceptives pursuant to subsection 1.
Sec. 11.  24-A MRSA §2847-G, sub-§4, as amended by PL 2021, c. 609, §3, is 
further amended to read:
4.  Coverage of contraceptive supplies.  Coverage required under this section 
subsection 1 must include coverage for contraceptive supplies in accordance with the 
following requirements.  For purposes of this section subsection, "contraceptive supplies" 
means all contraceptive drugs, devices and products approved by the federal Food and Drug 
Administration to prevent an unwanted pregnancy, except "contraceptive supplies" does 
not include nonprescription oral hormonal contraceptives.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a contraceptive supply, an insurer is not required to cover all those 
therapeutically equivalent versions in accordance with this subsection, as long as at 
least one is covered without any deductible, coinsurance, copayment or other cost-
sharing requirement in accordance with this subsection.
D.  Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies intended to last for a 12-month period, which may be furnished 
or dispensed all at once or over the course of the 12 months at the discretion of the 
health care provider.
Sec. 12.  24-A MRSA §2847-G, sub-§5 is enacted to read:
5.  Coverage of nonprescription oral hormonal contraceptives.  Coverage required 
under subsection 1-A must include coverage for nonprescription oral hormonal 
contraceptives approved by the federal Food and Drug Administration in accordance with 
the following requirements.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a nonprescription oral hormonal contraceptive, an insurer is not required 
to cover all those therapeutically equivalent versions in accordance with this 
subsection, as long as at least one is covered without any deductible, coinsurance, 
copayment or other cost-sharing requirement in accordance with this subsection.
C.  Coverage must be provided for the furnishing of nonprescription oral hormonal 
contraceptives intended to last for a 12-month period.
An insurer subject to this subsection shall establish mechanisms to ensure that an enrollee 
who purchases a nonprescription oral hormonal contraceptive has the option either to make 
the purchase at a pharmacy without a payment required at the point of sale or to make the 
purchase with a payment at the point of sale and submit a claim for reimbursement to the 
insurer.
Sec. 13.  24-A MRSA §4247, sub-§1, as reallocated by RR 1999, c. 1, §37, is 
amended to read:
1.  Coverage requirements; prescription contraceptives and outpatient 
contraceptive services.  All health maintenance organization individual and group health 
contracts that provide coverage for prescription drugs or outpatient medical services must 
provide coverage for all prescription contraceptives approved by the federal Food and Drug 
Administration or for outpatient contraceptive services, respectively, to the same extent 
that coverage is provided for other prescription drugs or outpatient medical services.  For 
purposes of this section, the term "outpatient contraceptive services" means consultations, 
examinations, procedures and medical services provided on an outpatient basis and related 
to the use of contraceptive methods to prevent an unintended pregnancy.  This section may 
not be construed to apply to prescription drugs or devices that are designed to terminate a 
pregnancy.
Sec. 14.  24-A MRSA §4247, sub-§1-A is enacted to read:
1-A.  Coverage requirements; nonprescription oral hormonal contraceptives.  All 
contracts required to provide coverage for prescription contraceptives under subsection 1 
must provide coverage for nonprescription oral hormonal contraceptives approved by the 
federal Food and Drug Administration to the same extent that coverage is provided for 
prescription contraceptives pursuant to subsection 1.
Sec. 15.  24-A MRSA §4247, sub-§4, as amended by PL 2021, c. 609, §4, is further 
amended to read:
4.  Coverage of contraceptive supplies.  Coverage required under this section 
subsection 1 must include coverage for contraceptive supplies in accordance with the 
following requirements.  For purposes of this section subsection, "contraceptive supplies" 
means all contraceptive drugs, devices and products approved by the federal Food and Drug 
Administration to prevent an unwanted pregnancy, except "contraceptive supplies" does 
not include nonprescription oral hormonal contraceptives.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a contraceptive supply, a health maintenance organization is not required 
to cover all those therapeutically equivalent versions in accordance with this 
subsection, as long as at least one is covered without any deductible, coinsurance, 
copayment or other cost-sharing requirement in accordance with this subsection.
D.  Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies intended to last for a 12-month period, which may be furnished 
or dispensed all at once or over the course of the 12 months at the discretion of the 
health care provider.
Sec. 16.  24-A MRSA §4247, sub-§5 is enacted to read:
5.  Coverage of nonprescription oral hormonal contraceptives.  Coverage required 
under subsection 1-A must include coverage for nonprescription oral hormonal 
contraceptives approved by the federal Food and Drug Administration in accordance with 
the following requirements.
A.  Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement.
B.  If the federal Food and Drug Administration has approved one or more therapeutic 
equivalents of a nonprescription oral hormonal contraceptive, an insurer is not required 
to cover all those therapeutically equivalent versions in accordance with this 
subsection, as long as at least one is covered without any deductible, coinsurance, 
copayment or other cost-sharing requirement in accordance with this subsection.
C.  Coverage must be provided for the furnishing of nonprescription oral hormonal 
contraceptives intended to last for a 12-month period.
A health maintenance organization subject to this subsection shall establish mechanisms to 
ensure that an enrollee who purchases a nonprescription oral hormonal contraceptive has 
the option either to make the purchase at a pharmacy without a payment required at the 
point of sale or to make the purchase with a payment at the point of sale and submit a claim 
for reimbursement to the health maintenance organization.
Sec. 17.  Application. This Act applies to all policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in this State on or after 
January 1, 2025. For purposes of this Act, all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date.
SUMMARY
This bill requires individual and group health insurance policies and contracts that are 
currently required to provide coverage for prescription contraceptives to provide coverage 
for nonprescription oral hormonal contraceptives approved by the federal Food and Drug 
Administration to the same extent that coverage is provided for prescription contraceptives. 
It requires insurers to establish mechanisms to ensure that an enrollee who purchases a 
nonprescription oral hormonal contraceptive has the option either to make the purchase at 
a pharmacy without a payment required at the point of sale or to make the purchase with a 
payment at the point of sale and submit a claim for reimbursement to the insurer.  The 
requirements apply beginning January 1, 2025.