Since the 1990s, many states have required insurers to provide “contraceptive equity,” meaning that insurance plans that cover prescription drugs must also cover contraception. However, insurance companies often limited the types of contraception that were covered or charged high copays for some or all forms. The Affordable Care Act (ACA) addressed some of these barriers by requiring coverage for all FDA-approved forms of female contraception with no copay. Many advocates and legislators worked to enshrine this requirement in their state law and to broaden the coverage guarantee even further, such as by including over-the-counter and/or male forms of contraception. In 2014, California became the first state to pass such a law, with Illinois, Maryland, and Vermont following suit in 2016.

In 2017, NIRH worked with NARAL Pro-Choice Massachusetts to take on this issue. They successfully advocating for the passage of the ACCESS (Advancing Contraceptive Coverage and Economic Security in our State) bill, which puts in place these kinds of state-level protections for contraceptive access. Among other provisions, Massachusetts law now requires coverage of contraception with no copay; requires insurance coverage without copay or prescription for over-the counter emergency contraception; and limits medical management techniques that pose barriers to contraceptive access.