Bill Overview
Title: Affordability is Access Act
Description: This bill establishes several requirements relating to health insurance coverage of, and access to, over-the-counter contraceptives. Specifically, the bill requires the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury to specify that private health insurance plans must cover over-the-counter contraceptives that are approved by the Food and Drug Administration (FDA), even without a prescription. Under current law, private health insurance plans (with some exceptions) must cover FDA-approved prescription contraceptives, without cost-sharing requirements. The bill also prohibits retailers from interfering with an individual's access to oral contraceptives that are meant for routine, daily use and are FDA-approved for use without a prescription.
Sponsors: Sen. Murray, Patty [D-WA]
Target Audience
Population: Individuals needing access to contraceptives, particularly women of reproductive age globally
Estimated Size: 65000000
- The global population of women of reproductive age (15-49) is approximately 1.9 billion.
- Access to contraception impacts both men and women, although directly it affects those seeking to use contraceptives—which are typically women.
- Contraceptive use can have broader societal impacts, including influencing family planning and economic conditions.
- Globally, not all women have access to contraceptives due to various economic, social, or regulatory reasons.
- Over-the-counter (OTC) availability of contraceptives is considered important for improving accessibility.
Reasoning
- The target population for this policy primarily includes women of reproductive age (15-49 years) in the United States, which is about 65 million individuals.
- The policy benefits those without insurance coverage for over-the-counter contraceptives and those facing access issues.
- Wellbeing impacts include financial burden reduction, increased contraceptive access, and potential for improved family planning outcomes.
- Budget constraints mean not all barriers can be addressed, and the policy mainly focuses on insurance and retail accessibility, not other access issues like rural or underserved areas.
- Interviews should include individuals from varied demographics to reflect diverse barriers and benefits within the target population.
Simulated Interviews
Marketing Specialist (New York City, NY)
Age: 32 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- I'm hopeful that this policy will make accessing oral contraceptives easier and less costly, as I currently have to go through my doctor each time I need a new prescription.
- I think this could relieve a lot of stress around contraception for women who may not have time or resources to make doctor's appointments.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Graduate Student (Oakland, CA)
Age: 24 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- Right now, it's hard for me to afford birth control, and the over-the-counter costs add up quickly. Making it covered by insurance would be a huge relief.
- I think making contraceptives more affordable and accessible could empower more women to take control of their reproductive health.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 4 |
| Year 5 | 9 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 6 | 3 |
Retail Worker (Rural Texas)
Age: 19 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Getting to a doctor for a prescription is practically impossible with my current work schedule and location, so I'm hopeful this policy will make things easier.
- If over-the-counter contraceptives become more accessible, it will be a big weight off my shoulders.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 3 |
| Year 5 | 8 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 5 | 3 |
Teacher (Chicago, IL)
Age: 45 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- I feel like this change will make it much simpler for those who find it difficult to prioritize another doctor's visit for a prescription.
- I see this as an advantage for both those new to contraceptives and those looking to maintain their routine.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Software Developer (Seattle, WA)
Age: 27 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 14/20
Statement of Opinion:
- Though I'm not directly impacted, I support policies that make reproductive health more accessible since it benefits my wife and our shared family planning efforts.
- Having more straightforward access to contraception removes some stress around planning for a family.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 6 | 5 |
Self-Employed Freelancer (Miami, FL)
Age: 40 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Accessing birth control has been more complicated since I became self-employed and lost regular insurance coverage.
- I think this policy could really simplify the process of getting contraception and could potentially lead to insurance plans that accommodate freelancers like me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 2 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 2 |
Nurse (Dallas, TX)
Age: 52 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 1.0 years
Commonness: 16/20
Statement of Opinion:
- While this doesn't impact me directly anymore, I know younger colleagues who really struggle with access in off-hours due to their healthcare shifts.
- I think increasing access without prescriptions is great for reducing unnecessary hurdles.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 8 | 8 |
| Year 5 | 8 | 8 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 6 |
Nonprofit Worker (Phoenix, AZ)
Age: 30 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 8.0 years
Commonness: 13/20
Statement of Opinion:
- This policy is aligned with my belief that contraception should be easily accessible to all women, regardless of their economic status.
- I hope this leads to broader conversations around access to other reproductive health resources.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Artist (Los Angeles, CA)
Age: 33 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- Being uninsured, I often have to choose between essential expenses and healthcare products like contraceptives.
- I believe this policy could make a massive difference for someone in my situation to maintain health without heavy costs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 2 |
Public Relations Specialist (Atlanta, GA)
Age: 29 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 14/20
Statement of Opinion:
- Though this policy isn't directly about my health, it's incredibly relevant as it impacts my spouse and our decision-making around family planning.
- It's about fairness and accessibility across the country for reproductive care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
Cost Estimates
Year 1: $3500000000 (Low: $3000000000, High: $4500000000)
Year 2: $3000000000 (Low: $2500000000, High: $4000000000)
Year 3: $3200000000 (Low: $2700000000, High: $4200000000)
Year 5: $2900000000 (Low: $2400000000, High: $3900000000)
Year 10: $2750000000 (Low: $2250000000, High: $3650000000)
Year 100: $2500000000 (Low: $2000000000, High: $3500000000)
Key Considerations
- Implementing coverage by health insurers could initially raise premium costs slightly, affecting consumers.
- Ensuring compliance with the prohibition on retailer interference could incur enforcement costs.
- The reduced burden of unintended pregnancies could translate into various socio-economic benefits over time.
- Public awareness and education campaigns might be necessary to maximize uptake of OTC contraceptives.