Executive Order 14101 · Signed Jun 23, 2023

88 FR 41815 · Published Jun 28, 2023 · Effective on signing

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Strengthening Access to Affordable, High-Quality Contraception and Family Planning Services

reproductive healthcontraception accesshealth insurance coveragefederal health programswomen's health

Signed by President Joseph R. Biden Jr.

Directs multiple federal agencies to consider expanding access to affordable contraception under private insurance, Medicaid, Medicare, military, veterans, and other federal health programs, building on prior executive actions taken after the Supreme Court's 2022 Dobbs decision.

Establishes a new round of agency-level reviews and potential guidance on contraceptive coverage, but the order itself does not change any regulation or create new benefits — all operative impact depends on future agency rulemaking and guidance.

What this order does

What it orders

The order directs the Secretaries of Treasury, Labor, and Health and Human Services to consider issuing guidance to improve access to contraception without out-of-pocket costs under the Affordable Care Act, covering all FDA-approved contraceptives and streamlining requests for medically necessary contraception. It also directs HHS to consider expanding family planning access through Medicaid and improving contraceptive coverage under Medicare Advantage and Part D. The Secretaries of Defense and Veterans Affairs and the Director of the Office of Personnel Management are directed to consider ensuring robust contraceptive coverage in their respective programs and educating beneficiaries. HHS is further directed to support Title X clinics, HRSA-funded health centers, and research into coverage gaps. The Secretary of Labor is to identify best practices for employer-sponsored health plans, and the Secretary of Education is to convene colleges to share best practices on contraception access.

The order's operative language is consistently qualified: agencies are instructed to "consider" taking steps "as appropriate and consistent with applicable law." It does not itself mandate new benefits, change any regulation, or override existing law. Any binding change would require future rulemaking, guidance issuance, or appropriations.

Who it affects

Women and people enrolled in private insurance, Medicaid, Medicare, military health plans, veterans' health programs, and students at colleges and universities who seek contraception. Federal agencies directing those programs are tasked with reviewing and potentially improving coverage and access.

Why it matters

If agencies follow through on the "consider" directives with actual guidance or rulemaking, millions of enrollees in private and federal health programs could see expanded contraceptive coverage with lower or no out-of-pocket costs. Until agencies act, nothing in the order itself changes coverage, pricing, or availability.

What must happen and when

How the order is supposed to work

Each directed agency independently decides what — if any — steps to take within its existing legal authority and available appropriations. There is no centralized reporting requirement or enforcement mechanism established by this order for the new directives. Coordination may occur through the Interagency Task Force on Reproductive Healthcare Access created by earlier executive orders. Actual impact is contingent on agencies issuing guidance or completing notice-and-comment rulemaking, which is not triggered automatically by this order.

Actions and deadlines

  • Consider issuing guidance to improve ACA contraceptive coverage without cost sharing, covering all FDA-approved methodsNo deadline specified
  • Consider actions to promote increased access to over-the-counter and emergency contraceptionNo deadline specified
  • Consider steps to expand family planning services and best practices under Medicaid managed careNo deadline specified
  • Consider improving contraceptive coverage and payment under Medicare Advantage and Part DNo deadline specified
  • Consider ensuring robust contraceptive coverage and educating beneficiaries in Defense, VA, and OPM programsNo deadline specified
  • Consider actions to support Title X clinics, HRSA-funded health centers, and research into contraception access gapsNo deadline specified
  • Identify and share employer best practices for affordable contraception coverage in private health plansNo deadline specified
  • Convene institutions of higher education to share best practices for contraception access for studentsNo deadline specified

Agencies directed to act

Department of the TreasuryDepartment of LaborDepartment of Health and Human ServicesDepartment of DefenseDepartment of Veterans AffairsOffice of Personnel ManagementDepartment of Education

Authority and reach

Authorities cited

Article II

Constitutional grant of executive power to the President.

Executive Order

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Executive Order 14101: Strengthening Access to Affordable, High-Quality Contraception and Family Planning Services | EO Reporter