Sponsors (4)
The bill expands and standardizes contraceptive coverage and mandates studies to identify and close program gaps—improving access and accountability for Medicare and dual‑eligible beneficiaries—while increasing federal and administrative costs and creating a delay before some benefits take effect.
Medicare beneficiaries (including seniors and people with disabilities) will get broader no‑cost contraceptive coverage — Part B services and items, Medicare Advantage cost‑sharing, and certain Part D contraceptive drugs will be exempt from cost‑sharing beginning in 2027 — reducing out‑of‑pocket costs and increasing access.
People dually eligible for Medicare and Medicaid will face fewer coverage gaps because Medicare contraceptive benefits must be at least as comprehensive as State Medicaid benefits, improving continuity of coverage for low‑income beneficiaries.
Required GAO/HHS studies and reports (on prescription access for people with disabilities, insurer/program coverage mapping, and dual‑eligibles) will produce data and actionable recommendations that enable targeted legislative or administrative fixes and faster policy responses.
Expanding free contraceptive coverage will increase federal Medicare and related program spending, potentially creating budgetary pressure and greater costs for taxpayers.
Implementing the changes will impose administrative and compliance burdens and costs on states, providers, Medicare Advantage and Part D sponsors, and federal agencies (updates to billing, formularies, plan design, annual reviews, and staff time).
Many provisions rely on studies and recommendations, so coverage gaps for people with disabilities, dual eligibles, and other beneficiaries may persist for up to one to two years before policy changes occur.
Based on analysis of 5 sections of legislative text.
Introduced December 18, 2025 by Margaret Wood Hassan · Last progress December 18, 2025
Requires Medicare (Parts B, C, and D) to cover FDA-recommended contraceptive items, services, and related drugs with no cost-sharing beginning January 1, 2027, and directs federal studies on prescription drug access and insurance coverage gaps. It expands the definition of covered contraceptive services under Medicare, sets payment and deductible rules, prohibits cost-sharing in Medicare Advantage and Part D for covered contraceptives, requires alignment for dual-eligible beneficiaries, and tasks HHS and the GAO with reports and recommendations to Congress within 1–2 years.