Closing the Contraception Coverage Gap Act
Sponsored By: Senator Maggie Hassan
Introduced
Summary
Would add no-cost contraceptive coverage to Medicare Part B. It would also remove cost-sharing for many contraceptive drugs under Part D and require HHS and the Government Accountability Office to produce guidance and studies on counseling and access.
Show full summary
- People on Medicare: Part B would cover a defined set of contraceptive items and related clinical services with no cost-sharing, effective January 1, 2027. Payments would be 100 percent of the lesser of the actual charge or a Secretary-set payment basis.
- People with Medicare drug coverage: For plan years beginning after January 1, 2027 there would be no deductible or coinsurance for contraceptive drugs described in HHS guidance.
- Dual-eligible beneficiaries: The Secretary must ensure Medicare coverage for contraceptive items and drugs is at least as comprehensive as each beneficiary’s State plan or waiver, subject to an annual review.
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 6 benefits, 0 costs, 0 mixed.
Medicare Advantage contraception cost rules
If enacted, Medicare Advantage plans would treat contraceptive items and services as a specified subcategory for coverage and cost-sharing rules in plan years beginning on or after January 1, 2027. Plans would set cost-sharing under that rule, which could lower your copays or coinsurance depending on the plan. This aligns Part C plan rules with the new contraceptive coverage definitions.
Medicare and Medicaid contraception parity
If enacted, HHS would have to make sure Medicare coverage for people dually eligible for Medicare and Medicaid is at least as broad as their State Medicaid coverage, based on an annual review. The GAO would also study coverage differences for dual-eligibles and report to Congress with recommendations within two years. These steps aim to close coverage gaps for people on both programs.
New Medicare Part B contraception coverage
If enacted, Medicare Part B would cover contraceptive items, counseling, and related clinical services starting January 1, 2027. The items must be furnished by a doctor or practitioner and follow January 12, 2022 guidance on patient-centered counseling. The bill would require Part B to pay 100% of the lower of the provider charge or a Secretary-set payment amount, and the Part B deductible would not apply. The bill would also change exclusion rules for items not ordered by a physician and let HHS create quality measures for counseling and access.
No Part D cost-sharing for contraceptives
If enacted, for plan years starting on or after January 1, 2027, covered Part D drugs that may be used for contraception would not be subject to the Part D deductible and would have no coinsurance or other cost-sharing. These drugs would be treated as preventive Part D drugs. Low-income subsidy-eligible enrollees would also owe no deductible or cost-sharing for these contraceptive drugs.
Study of contraception coverage gaps
If enacted, the Government Accountability Office would study insurance types that are not required by law to cover all FDA-approved contraception or to waive cost-sharing. The GAO must report to Congress with recommendations within one year. The study would cover commercial plans and public programs like Medicaid, Medicare, and TRICARE.
Study: drug access for disabled Medicare
If enacted, HHS would study whether people with disabilities on original Medicare Parts A and B (and not enrolled in Part C or D) can access prescription drugs, including oral contraceptives. The study would also look at options to cover over-the-counter contraceptives under Medicare A/B with no cost-sharing. HHS must report to Congress with recommendations within one year of enactment.
Sponsors & CoSponsors
Sponsor
Maggie Hassan
NH • D
Cosponsors
Lisa Murkowski
AK • R
Sponsored 12/18/2025
Tammy Duckworth
IL • D
Sponsored 12/18/2025
Susan Collins
ME • R
Sponsored 12/18/2025
Roll Call Votes
No roll call votes available for this bill.
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