AUGUSTA — Maine lawmakers are considering a proposal to require health insurance plans to cover non-prescription contraceptives such as a new over-the-counter birth control pill.

State law already requires insurance coverage of prescription contraceptives without any deductible, co-payment or other cost-sharing requirement. A new bill, L.D. 2203, would expand that to include non-prescription contraceptives including Opill, which the U.S. Food and Drug Administration approved in July.

It also would require coverage of such over-the-counter contraceptives as condoms, spermacides and the so-called morning-after pill.

“Maine people depend on these products to prevent unwanted pregnancies and plan their families,” Rep. Poppy Arford, D-Brunswick, the bill’s sponsor, said during a public hearing Tuesday. “They have a right to a full range of affordable, non-prescription reproductive health products.”

Arford said she was inspired to introduce her bill after the approval of Opill, which is the first daily oral contraceptive approved for over-the-counter sale.

The proposal comes as states around the country are debating reproductive rights in the wake of Dobbs v. Jackson Women’s Health Organization, the 2022 U.S. Supreme Court decision overturning the federal right to an abortion.

At least six states – California, Maryland, New Jersey, New Mexico, New York and Washington – already have laws or regulations requiring state-regulated private health insurance plans to cover 100% of the cost of over-the-counter contraception without a prescription, according to KFF, a San Francisco-based health policy and research organization.

The Legislature’s Joint Standing Committee on Health Coverage, Insurance and Financial Services mostly heard testimony in favor of the bill during a public hearing Tuesday. It now will be scheduled for a work session and committee vote at a later date.

All co-sponsors on the measure are Democrats. No Republican lawmakers testified either for or against the proposal Tuesday, although their support isn’t necessarily needed if the majority Democrats have enough support within their party.

The Mills administration did not support or oppose the bill Tuesday. The Maine Bureau of Insurance submitted written testimony to the committee neither for nor against the bill. However, Timothy Schott, the bureau’s acting superintendent, said he would not consider the proposal to be a new mandated health benefit but rather an expansion of existing preventive benefits.

Reproductive rights advocates and medical professionals encouraged the committee to support the bill.

“Birth control is, as we know, popular, effective and essential to reproductive freedom,” Lisa Margulies, vice president of public affairs for Planned Parenthood Maine Action Fund, said on Tuesday.

Despite the social and economic benefits of birth control, Margulies said, barriers exist even in states that have expanded access, including financial issues, transportation or “living in a contraceptive desert.”

“Increasing access to birth control is an essential element of protecting reproductive freedom in an uncharted post-Dobbs landscape,” she said. “This bill would ensure more Mainers have access to the contraception they need, when they need it.”

The Maine Medical Association and Maine Osteopathic Association also submitted testimony in support of the bill.

“MMA and MOA are supportive or any measure that ensures increased access to birth control as our country grapples with ongoing attacks to reproductive autonomy including access to abortions,” said Austin Vaughan, a medical student who submitted testimony on behalf of the associations. “Our patients need to know they have options in this uncertain world and this bill would provide that to them.”

INSURERS HAVE CONCERNS

Dan Demeritt, executive director of the Maine Association of Health Plans, said health insurers and carriers are concerned about how the bill would work.

“Medical identity theft is a huge problem when it comes to health care, and insurance only works … when we know that the person who is covered by the plan is using the product,” Demeritt said. “We’re concerned about how do you operationalize this when you can go into a convenience store and buy condoms that are FDA-approved. How do we make this work in terms of submitting a claim?”

Kristine Ossenfort, director of government relations for Anthem Blue Cross and Blue Shield in South Portland, said the company is concerned about a “slippery slope” for requiring insurance coverage for over-the-counter medications. “That can become, potentially, extremely expensive,” Ossenfort said.

Medical insurance typically covers prescription medications, and the bill’s sponsor was not aware of other requirements that over-the-counter drugs be covered in Maine. The Maine Bureau of Insurance did not answer a question Tuesday about whether Maine requires coverage of any non-prescription drugs.

In his written testimony, Schott, the bureau’s acting superintendent, said he would consider the proposed requirement to be an expansion of existing preventive benefits.

Ossenfort said her company disagrees with that assessment and does see the proposal as a new mandate.

“If you are interested in increasing access further, we would encourage you to explore means that would make it easier to get this medication with a prescription,” she told the committee.

Arford doesn’t see the proposal as setting a precedent for other over-the-counter drugs to be subject to required insurance coverage.

“Reproductive health care, that category of health care products and services, is something we value so highly in our state that we have passed laws to make it affordable and available for the people who live and work here in ways we have not for other products,” she said.

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