Affordability is Access Act of 2026
- Sponsor
- Sen. Murray, Patty [D-WA]
- Committees
- Health, Education, Labor, and Pensions Committee (primary)
- Last action
- Sep 24, 2026
Bottom line
The bill aims to significantly expand access to affordable contraception by requiring insurance coverage for FDA-approved over-the-counter options and reinforcing coverage for prescription methods, while also addressing retail access barriers.
What it actually does
This bill mandates that group health plans and health insurance coverage provide coverage for over-the-counter (OTC) contraceptives approved by the Food and Drug Administration (FDA) without requiring a prescription or cost-sharing. It also clarifies that coverage for prescription contraceptives is required, though for therapeutically equivalent drugs, only one such option needs to be covered. Additionally, the bill prohibits retailers from interfering with an individual's access to or purchase of OTC contraception.
Proponents argue
Proponents argue that this legislation is a crucial step to eliminate financial and logistical barriers to birth control, ensuring timely and affordable access to essential reproductive healthcare. They contend it will improve health outcomes for women, trans men, and nonbinary people, address existing access gaps, and particularly benefit marginalized communities who face disproportionate challenges in obtaining care.
Opponents contend
Opponents might argue that mandating coverage for OTC contraceptives could lead to increased insurance premiums for all policyholders and employers, imposing new financial burdens on health plans and retailers. Concerns may also be raised about federal overreach into private healthcare decisions or the potential for the bill to expand beyond the scope of existing preventive care mandates.
The bill is concise and clearly structured, allowing an informed reader to understand its core provisions and implications within a short timeframe.
Section 2
Purpose of the Act
This section explicitly states the bill's primary goal: to ensure timely access to affordable birth control. It achieves this by requiring health insurance plans to cover contraceptives that are approved by the Food and Drug Administration (FDA) for use without a prescription, and to do so without any cost-sharing (like co-pays or deductibles) for the individual.
Supporters argue
Supporters argue that clearly stating the purpose reinforces the bill's intent to remove financial barriers, which is critical for reproductive health equity and aligns with public health goals.
Critics contend
Critics might argue that while the purpose is clear, it sets the stage for mandates that could increase healthcare costs, potentially leading to higher premiums for all insured individuals.
Tradeoffs
The provision balances the goal of universal affordable access to contraception against the potential for increased costs for health plans and, indirectly, for consumers through higher premiums.
Section 3
Congressional Findings on Contraceptive Access
This section outlines the factual basis and rationale for the bill, emphasizing that birth control is essential healthcare used by a vast majority of women, trans men, and nonbinary people. It highlights the health benefits of contraception, existing gaps in access (especially due to cost), and how systemic discrimination disproportionately affects access for low-wage earners, people of color, LGBTQ+ individuals, immigrants, and people with disabilities.
Section 5
Clarifying Contraceptive Coverage Requirements
This is the core operative section of the bill. It directs federal agencies to clarify that health plans must cover two types of contraceptives: (1) all over-the-counter (OTC) contraceptives approved by the FDA, even without a prescription, and without cost-sharing; and (2) all prescription contraceptives approved by the FDA. For prescription drugs, if there are multiple therapeutically equivalent options, plans are only required to cover one of them.
Section 7
Duties of Retailers Regarding OTC Contraception
This section requires any retailer that stocks FDA-approved over-the-counter (OTC) contraception not to interfere with an individual's ability to access or purchase such products, or with their access to medically accurate information about them. However, it explicitly states that a retailer is not prohibited from refusing to provide a contraceptive product if the individual is unable to pay for it, either directly or through insurance.
For prescription drug contraceptives, coverage is required for all FDA-approved options, but if multiple therapeutically equivalent drugs exist, coverage is only required for one such option.
Section 5(2)
Why it matters:This is standard legislative practice for managing drug coverage and cost control within insurance mandates, aiming to balance patient access with economic efficiency by allowing insurers to choose among equivalent options.
Case for: Proponents of this specific clause argue it prevents unnecessary cost increases for insurers by not requiring them to cover every single brand of a therapeutically equivalent drug, thereby helping to manage premiums. It ensures that an effective option is always available.
Case against: Critics might argue that this provision could limit patient choice, as individuals may have preferences for specific brands or formulations of therapeutically equivalent drugs due to minor differences in side effects, inactive ingredients, or personal experience. This could lead to less optimal outcomes for some patients.
Estimated impact: This provision could affect the range of prescription contraceptive options available without cost-sharing for insured individuals, potentially shifting market dynamics among pharmaceutical companies producing therapeutically equivalent drugs.
The bill clarifies that retailers are not prohibited from refusing to provide an individual with an OTC contraceptive product if the individual is unable to pay for it, whether directly or through insurance.
Section 7(b)
Why it matters:This is a standard clarification to ensure that a mandate to not 'interfere' with access does not implicitly create a requirement for retailers to provide products for free, which would be an unreasonable business expectation. It maintains the principle of payment for goods.
Case for: Proponents argue this carve-out is a practical and necessary clarification that protects retailers from being forced to absorb costs, making the broader mandate on non-interference more palatable for businesses.
Case against: Critics might argue that while understandable from a business perspective, this limitation still leaves a significant barrier for individuals who cannot afford OTC contraception, even if insurance coverage is mandated. It highlights that affordability remains an issue for the uninsured or those with high deductibles.
Estimated impact: This provision clarifies that the bill does not create a universal free access program at the retail level, meaning individuals without insurance or the means to pay will still face financial barriers to OTC contraception.