Sponsors (4)
The bill expands and clarifies contraceptive coverage for Medicare populations—reducing out‑of‑pocket costs and improving transparency and program guidance—while increasing federal spending and implementation burdens and relying on studies that delay some policy fixes.
Medicare beneficiaries (including women) will get broader, no cost‑sharing coverage of contraceptive items and services starting in 2027 — including Part B coverage, Medicare Advantage supplemental coverage, and Part D exemptions — reducing out‑of‑pocket costs for many enrollees.
Dual‑eligible beneficiaries and people with disabilities will have clearer protections and potential parity (Medicare at least as comprehensive as state Medicaid) improving consistent access to contraceptives for low‑income and disabled populations.
HHS direction (clarified coverage scope and required guidance plus quality measures) should improve consistency and quality of contraceptive counseling and service delivery across providers and plans.
Expanding Medicare contraceptive benefits will increase federal Medicare spending and pressure the Supplementary Medical Insurance Trust Fund, potentially leading to higher premiums, additional federal costs, or the need for offsets.
Providers, Medicare Advantage organizations, and Part D sponsors will face administrative and compliance burdens to implement new coverage rules, guidance, and quality measures.
Some beneficiaries could see indirect costs if plans change benefit design or raise premiums to absorb added coverage, shifting costs to middle‑class families or other enrollees.
Based on analysis of 5 sections of legislative text.
Requires Medicare Part B to cover contraceptive items and services with no cost-sharing beginning Jan 1, 2027, and mandates studies on coverage gaps and access.
Introduced December 18, 2025 by Margaret Wood Hassan · Last progress December 18, 2025
Requires Medicare Part B to cover a broad range of contraceptive items and services without cost-sharing beginning January 1, 2027, and instructs the Department of Health and Human Services and the Government Accountability Office to study gaps in contraceptive drug and program coverage for Medicare beneficiaries, dual eligibles, and other insurance programs. The bill defines covered contraceptive items and services, exempts them from Part B deductibles, sets payment rules, and directs the Secretary to issue guidance on patient-centered counseling and related services.