Providing for access to contraceptives; imposing duties on the Insurance Department and the Department of Human Services; providing for severability; and imposing penalties.
HB1140, titled the Contraceptive Access for All Act, would require most Pennsylvania health insurance policies and MA/CHIP managed care plans to cover a broad range of contraceptive services and products. Covered items include FDA-approved contraceptive drugs and devices, over-the-counter emergency contraception and oral contraceptives when prescribed or covered by a standing order, 3-month initial supplies of oral contraceptives, 12-month refills or subsequent supplies, voluntary sterilization surgery for adults, and related counseling, screening, insertion, removal, and other integral services. The bill also bars cost sharing for covered contraceptive care in most circumstances and prohibits prior authorization or step therapy for certain over-the-counter contraceptives.
The bill further directs the Secretary of Health or Physician General to issue a statewide standing order allowing authorized providers to dispense or distribute FDA-approved over-the-counter emergency contraceptives and oral contraceptives. It includes confidentiality protections for enrollees and covered persons who need communications about contraceptive care sent to alternative addresses or by alternative means, and it requires annual reporting by insurers and managed care plans on complaints, grievances, appeals, and adverse benefit determinations related to contraceptive care. Enforcement authority would rest with the Insurance Commissioner and the Department of Human Services, with penalties including fines, license suspension or revocation, and other remedies under existing insurance laws.
In terms of state law impact, the bill would add a new statewide contraceptive coverage mandate and create new administrative duties for both the Insurance Department and the Department of Human Services. It would amend the practical operation of Pennsylvania insurance regulation by tying contraceptive coverage to existing insurance and managed care frameworks, while also incorporating references to prior authorization, step therapy, and consumer complaint reporting under current law. The bill would apply prospectively to new or renewed policies and includes severability and a 60-day effective date.
The general sentiment reflected in the House votes suggests support for the bill but with meaningful division. It advanced out of the House Insurance Committee on a narrow 14-12 vote, then failed on an initial floor vote, but later passed final House consideration 116-87. That pattern indicates the measure was politically significant and ultimately supported by a majority, though not without substantial opposition.
The main points of contention are likely the scope of the mandated coverage, the prohibition on cost sharing, the statewide standing order, and the bill’s interaction with religious and moral exemptions. The bill expressly exempts certain objecting entities under federal religious and moral exemption rules, but opponents may still object to the breadth of the mandate and the requirement that employers or insurers provide notice when coverage is limited. Supporters appear to favor expanding access, reducing out-of-pocket costs, and standardizing access to contraception across insurance products and managed care plans.
HB1140 would create a new chapter of requirements for health insurers and MA/CHIP managed care plans in Pennsylvania, mandating coverage of contraceptive drugs, devices, emergency contraception, oral contraceptives, sterilization, and related services without cost sharing in most cases. It would also authorize a statewide standing order for certain over-the-counter contraceptives, require confidentiality accommodations, impose annual reporting obligations, and establish enforcement penalties administered by the Insurance Department and Department of Human Services. The bill would affect insurers, managed care plans, health care providers, employers with objecting coverage, and insured individuals seeking contraceptive care.
The bill appears to have drawn generally favorable support among House members overall, but with clear partisan and policy division. Its narrow committee passage and failed initial floor vote show that it was contested, while final passage by a larger margin indicates enough support to move it forward. The voting history suggests strong backing from supporters of contraceptive access and substantial resistance from opponents concerned about mandates and exemptions.
The most notable contention centers on whether the Commonwealth should require broad contraceptive coverage, eliminate cost sharing, and compel a statewide standing order for over-the-counter contraceptives. Opponents are also likely focused on the bill’s impact on insurers, employers, and religious or moral objectors, even though the bill contains exemptions and notice requirements. Supporters, by contrast, emphasize access, affordability, continuity of coverage, and privacy protections for people seeking contraceptive care.