Senate Passes the ACCESS Bill to Expand Contraceptive Mandate

BOSTON – On Nov. 14, The Massachusetts Senate voted 27-0 to enact H.4009, An Act advancing contraceptive coverage and economic security in our state, better known as the ACCESS Bill. In October, the bill was revised as a result of a compromise between legislators, the Coalition for Choice, and a group of Massachusetts insurance carriers – who now vocally support the legislation.

Filed in early January, the ACCESS Bill was viewed as both a safeguard and a worst-case-scenario means to shield Massachusetts women from regressive healthcare policy rollbacks by the federal government. The legislation simultaneously expands upon a 2006 Massachusetts contraceptive-coverage mandate and upon co-pay free contraceptive-coverage provisions enacted under the 2010 Affordable Care Act (ACA).

A sense of urgency to pass the ACCESS Bill was renewed with Congress’ summertime attempts to repeal the ACA, and was further stirred by the Trump Administration’s contraceptive-coverage rollback in early October. Under the bill, health plans have six months to comply with the new mandates.

“At a time when women’s health and reproductive rights are under unprecedented attack at the federal level, Massachusetts has taken the lead once again to safeguard over 1 million women who depend on access to no-copay birth control and to expand coverage for everyone. All women, regardless of economic status, should have access to affordable birth control of their choice, and the ACCESS Bill guarantees that,” said Senator Cindy Friedman (D-Arlington).

The ACCESS Bill mandates that more options, like IUDs, be covered co-pay free. It also allows women to purchase full-year supplies of their medication in just one pharmacy visit. A mandatory benefit review conducted by the Massachusetts Center for Health Information Analysis (CHIA) estimated meager premium hikes as a result of the expanded mandate. Individuals might see increases in the range of $.07 – $.20 on their monthly premiums over five years.

However, according to a 2017 Health Policy Commission report and a 2012 federal Health and Human Services publication, the cost of co-pay free contraception is mitigated by cost savings derived from preventing unintended pregnancies.[1] The HHS report defines the cost of co-pay free contraception as “close to zero.”[2]

The benefits of contraceptive care are immense and well documented. As cited in the legislation’s CHIA review, benefits of contraception include: “improved women’s health and well-being, reduced maternal mortality, health benefits for mother and child associated with spacing pregnancy, female workforce engagement, and economic self-sufficiency.”

The bill now moves to the Governor’s desk for approval.



[1]Hpc DataPoint 3: Contraception Spending and Utilization.” 2017 June. Boston, MA: Massachusetts Health Policy Commission.

[2] Bertko et al. “The cost of covering contraceptives through health insurance.” 2012 Feb. Washington, DC: Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human services.