Sanders calls for investigation into birth control insurance coverage

Sen. Bernie Sanders (I-Vt.) is calling on a government watchdog to investigate why some health insurance plans are charging women for contraception, in violation of federal law that requires it to be free. 

In all 50 states, the Affordable Care Act (ACA) guarantees coverage of women’s preventive services, including all birth control methods approved by the Food and Drug Administration. 

But in a letter sent Monday to the Government Accountability Office, Sanders said insurers are still charging customers, and in some cases denying coverage requests. 

“The ACA has been federal law for 14 years and we continue to see plans deny coverage and ignore the federal mandate," Sanders wrote. "It is completely unacceptable that plans consistently defy mandated coverage and that there is little enforcement or accountability."

He cited a recent Vermont investigation that found three health insurers in the state — Blue Cross Blue Shield Vermont, MVP Health Care and Cigna Healthcare — inappropriately charged patients $1.5 million for contraceptives that should have been provided free of any out-of-pocket costs.  

In addition, Sanders said an October 2022 investigation by the House Oversight and Accountability Committee found that health plans and pharmacy benefit managers defy ACA requirements and exclude or impose cost-sharing on at least 34 contraceptive products. 

According to the committee’s report, between 2015 and 2021, a majority of the insurance companies surveyed denied an average of 40 percent or more of exception requests for contraceptive products, with one company denying more than 80 percent of requests each year. 

A follow-up staff report in 2023 found that many patients covered by five of the largest health insurers and four of the largest pharmacy benefit managers face coverage exclusions and other restrictions on birth control products, contrary to the ACA.    

In January, the Biden administration proposed an expansion of contraceptive coverage, including removing moral exemptions finalized under the Trump administration that made it easier for private health plans and insurers to exclude coverage of birth control. 

Administration health agencies issued guidance for private insurers to cover, for free, a broader range of federally approved contraceptives under the Affordable Care Act. 

Contraception access has become a political battle, and Democrats have been leaning into protecting birth control as part of their election-year push on reproductive rights, looking to emphasize Republican efforts opposing protections many voters say they support.