Robust Contraceptive Equity Law Goes into Effect

Expanding Access to Contraceptive Care Without Cost-Sharing for Millions of Californians

Sacramento, CA – New contraceptive coverage policies outlined in the Contraceptive Equity Act of 2022 took effect January 1, 2024 modernize birth control access in California. The state has long been a leader in expanding access to essential health services and will now require coverage of over-the-counter birth control options and vasectomy services without cost-sharing, expand contraceptive coverage benefits to state employees and individuals enrolled in university or college health plans, and clearly prohibit employers from discriminating against their employees based on their contraceptive and reproductive health decisions. 

In response to the law taking effect, SB 523 co-sponsors Essential Access Health, the National Health Law Program, and Reproductive Freedom for All California (formerly NARAL Pro-Choice California) released the following statements:

“California is now slated to have the most comprehensive and inclusive contraceptive coverage requirements in the nation. The new policies in place will expand access to time-sensitive and potentially life-changing contraceptive care that is essential for our individual, family, and community health and well-being,” said Amy Moy, Co-CEO at Essential Access Health. “All Californians, regardless of their income, gender identity, health insurance plan, or where they live, work, or go to school need and deserve equitable access to birth control without any unnecessary delays or discrimination.”

“Today, California once again solidifies itself as a national leader in reproductive health by making contraceptives more accessible and allowing individuals to make their own decisions about their health care,” said Christina Piecora, Senior Policy Analyst at the National Health Law Program. “Effective now, SB 523 helps ensure contraceptive care is accessible to all Californians regardless of income, gender identity, or health plan, by requiring coverage of over-the-counter birth control options and vasectomy services without cost-sharing, expanding contraceptive coverage benefits to state employees and individuals enrolled in university or college health plans, and prohibiting employers from discriminating against their employees based on their contraceptive and reproductive health decisions. Extending over-the-counter contraceptive coverage without a prescription is crucial in achieving health equity. While contraceptive equity has always been an important component of reproductive health, it is even more critical amidst escalating attacks on sexual and reproductive health care after Dobbs. The National Health Law Program is a proud co-sponsor of SB 523 and will work to ensure the law’s swift implementation.”

“Reproductive Freedom for All California was proud to cosponsor SB 523, and we are thrilled that it has gone into effect as of January 1st,” said Shannon Olivieri Hovis, Director at Reproductive Freedom for All California. Equitable access to birth control is a critical facet of reproductive freedom, and this important law will extend contraceptive coverage benefits to millions of Californians, regardless of their insurance status, gender identity, or place of employment. Thank you to former Senator Leyva, Governor Newsom, and our incredible coalition partners for their collaboration.”

Background 

SB 523 - the Contraceptive Equity Act of 2022, authored by former Senator Connie M. Leyva was signed into law in 2023. 

The Affordable Care Act (ACA) requires most health insurance carriers to cover the full range of birth control methods approved by the Food and Drug Administration (FDA) including sterilization services, without any out-of-pocket costs. In 2014, California enacted SB 1053 (Mitchell) to codify the ACA’s contraceptive coverage mandate into state law. The measure required Medi-Cal managed care and health plans to provide access to the full range of FDA-approved contraceptive methods for all insured individuals without cost-sharing, delays or denial of coverage. 

Since SB 1053 was enacted, several states have expanded access to birth control even further by requiring health plans to cover over-the-counter birth control pills, condoms and vasectomies and other male birth control methods. Also, in 2016, SB 999 (Pavley)—ensuring that most health insurance plans in California cover a year’s supply of birth control dispensed at once—was chaptered.  California was a pioneer in enacting these measures and, since then, other states have built on the state’s success. 

Despite this progress, health disparities in reproductive health outcomes continue to persist among Black, Indigenous and People of Color (BIPOC), including disproportionate unintended pregnancy, infant and maternal mortality, and STD rates. The COVID-19 public health emergency has also further highlighted the structural inequities that disproportionately affect youth, low-income people and communities of color in accessing birth control services. A report by the Guttmacher Institute revealed that 38 percent of Black women and 45 percent of Latinas—compared to 29 percent of white women—now face difficulties accessing birth control as a result of the pandemic. Lower-income women were also more likely than higher-income women to report having experienced delays or having been unable to get contraceptive care because of the pandemic (36 percent vs. 31 percent).