November 16, 2016 / Press Releases

Fast Facts: State of contraceptive coverage in the United States

November 16, 2016

Repealing the ACA would mean higher birth control costs and fewer options for majority of U.S. women.

Donald Trump on the Affordable Care Act and contraceptive coverage:

Throughout his campaign, Donald Trump has vowed to repeal the Affordable Care Act (ACA), which gives millions of women access to affordable birth control through its contraceptive-coverage policy. The anti-choice GOP has fought this policy from day one. While Trump has indicated he might keep some parts of the ACA, Rep. Paul Ryan’s reluctance to get into the “nitty gritty details” when asked if birth-control coverage would end or remain indicates this landmark policy is at risk.

In recent days, women have rushed to their doctors in fear that birth control will soon be too expensive and hard to get under a Trump presidency. If the ACA’s contraceptive coverage policy is repealed, the majority of women will see their birth control become more expensive and their options for birth control diminish.

What this could mean for women:

The ACA vastly expanded the number of women who could access birth control by guaranteeing that most health-insurance plans cover contraception without a copay. The contraceptive-coverage policy has saved women an estimated $1.4 billion a year on contraceptives and put previously too-expensive forms of contraception—such as the IUD—in reach.

If this vital part of the ACA is repealed, women will be affected differently depending on what state they are in. Although some will still enjoy insurance coverage of birth control without a copay, most will see costs rise and coverage decline.

If the ACA is repealed:

  • Women in states without essential backstops to the federal contraceptive benefit and who have private insurance risk losing access to affordable contraception of all types. If the ACA’s contraceptive-coverage policy is repealed, millions women who need access to affordable contraceptives would be no longer have that access. This includes women in the 23 states that do not require insurers to cover prescription contraception like other medications (AL, AK, FL, ID, IN, KS, KY, LA, MN, MS, MO, NE, ND, OH, OK, PA, SC, SD, TN, TX, UT, VA, and WY).
  • Women in many states would face higher costs and more limited options when deciding which type of birth control is best for them. Insurers are required to cover prescription contraception to the same extent as other medication in 27 states (AZ, AR, CA, CO, CT, DE, GA, HI, IL, IA, ME, MD, MA, MI, MT, NV, NH, NJ, NM, NY, NC, OR, RI, VT, WA, WV, and WI). But this does not mean that women would have the same access to contraception afforded by the ACA. Under these laws, insurers can still charge copays for contraception and limit the types or even brands covered by insurance.
  • As it stands, women would not lose contraceptive coverage in only three states (CA, IL, and MD). These states they require health-insurance plans to cover each unique contraceptive protect at no cost. This benefit exceeds birth-control coverage under the ACA.


Everyone should be able to decide if, when, how, and with whom they start or grow a family.

Sign up for Updates
By taking this action you are affirming your membership in NARAL Pro-Choice America. What's this?
By providing your phone number, you are consenting to receive mobile alerts from NARAL Pro Choice America at 59791. Message and data rates apply. Frequency varies. Text STOP to end. Text HELP for help. Privacy Policy and Terms & Conditions.