[Federal Register Volume 88, Number 123 (Wednesday, June 28, 2023)]
[Presidential Documents]
[Pages 41815-41818]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-13889]


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                         Presidential Documents 
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  Federal Register / Vol. 88 , No. 123 / Wednesday, June 28, 2023 / 
Presidential Documents  

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 Title 3--
 The President

[[Page 41815]]

                Executive Order 14101 of June 23, 2023

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

                By the authority vested in me as President by the 
                Constitution and the laws of the United States of 
                America, it is hereby ordered as follows:

                Section 1. Policy. Women should have access to the 
                healthcare they need, including contraception and 
                family planning services. Access to contraception is 
                essential to ensuring that all people have control over 
                personal decisions about their own health, lives, and 
                families. High-quality contraception improves health 
                outcomes, advances economic stability, and promotes 
                women's overall well-being. Contraception access is 
                linked to improved maternal and child health, expanded 
                educational and professional opportunities, and higher 
                lifetime earnings.

                Through new requirements for private health coverage 
                and expanded access to Medicaid, the Affordable Care 
                Act extended access to affordable contraception to 
                millions of women, helping them save billions of 
                dollars on birth control. Yet access to high-quality 
                contraception continues to vary based on income, 
                location, health insurance coverage, and the 
                availability of healthcare providers. Millions of 
                people continue to face barriers to obtaining the 
                contraception they need even as access has become more 
                critical in the wake of the Supreme Court's decision in 
                Dobbs v. Jackson Women's Health Organization, 142 S. 
                Ct. 2228 (2022), to overturn Roe v. Wade, 410 U.S. 113 
                (1973).

                Given that the Supreme Court overruled Roe, which 
                rested on the fundamental right to privacy in matters 
                of health, bodily autonomy, and family, it has never 
                been more important to protect and expand access to 
                family planning services. Dobbs has already had, and 
                will continue to have, devastating implications for 
                women's health. In States with laws that restrict 
                access to abortion, health clinics that provide 
                contraception and other essential health services have 
                shuttered, eliminating critical points of care. Some 
                State officials have adopted policies interfering with 
                access to emergency contraception, including for 
                vulnerable populations. Such policies further threaten 
                women's ability to make decisions about their own 
                bodies, families, and futures. These threats persist 
                despite decades of Supreme Court precedent, beginning 
                with Griswold v. Connecticut, 381 U.S. 479 (1965), and 
                Eisenstadt v. Baird, 405 U.S. 438 (1972), affirming the 
                right to contraception. Moreover, an overwhelming 
                majority of Americans support access to contraception.

                In the wake of the Supreme Court's decision in Dobbs, I 
                issued Executive Order 14076 of July 8, 2022 
                (Protecting Access to Reproductive Healthcare 
                Services), and Executive Order 14079 of August 3, 2022 
                (Securing Access to Reproductive and Other Healthcare 
                Services), to direct my Administration to take action 
                to protect access to reproductive healthcare services, 
                including contraception and abortion. In Executive 
                Order 14076, I directed the Secretary of Health and 
                Human Services and the Director of the Gender Policy 
                Council to establish an Interagency Task Force on 
                Reproductive Healthcare Access to coordinate these 
                efforts across my Administration. Consistent with these 
                Executive Orders and other applicable authorities, 
                executive departments and agencies have taken numerous 
                steps to protect and strengthen access to 
                contraception, including:

[[Page 41816]]

                    (a) issuing guidance and convening sponsors of 
                employee benefit plans and health insurers to clarify 
                contraception coverage requirements under the 
                Affordable Care Act;
                    (b) expanding walk-in contraceptive care services 
                for active duty service members and other Military 
                Health System beneficiaries;
                    (c) issuing a Notice of Proposed Rulemaking to 
                improve access to affordable contraception for certain 
                dependents of veterans;
                    (d) providing additional funding to bolster 
                training, develop and expand telehealth infrastructure 
                and capacity, and provide technical assistance for 
                clinics funded under Title X of the Public Health 
                Service Act (42 U.S.C. 300 et seq.) (Title X);
                    (e) strengthening the inclusion of family planning 
                providers in insurance networks for qualified health 
                plans under the Affordable Care Act;
                    (f) issuing a Notice of Proposed Rulemaking to 
                provide a new pathway for women to access 
                contraceptives when their private health coverage is 
                exempt from covering this benefit;
                    (g) issuing a Notice of Proposed Rulemaking to 
                strengthen privacy protections under the Health 
                Insurance Portability and Accountability Act of 1996, 
                Public Law 104-191, 110 Stat. 1936, as amended by 
                Public Law 111-5, 123 Stat. 115 (2009), by proposing to 
                prohibit doctors, other healthcare providers, and 
                health plans from using or disclosing individuals' 
                protected health information related to lawful 
                reproductive healthcare, such as contraception use, 
                under certain circumstances;
                    (h) issuing a Notice of Proposed Rulemaking to 
                ensure healthcare providers that receive Federal 
                financial assistance do not deny healthcare, including 
                contraception, on the basis of any ground protected by 
                Federal law; and
                    (i) reminding Health Resources and Services 
                Administration (HRSA)-funded health centers of their 
                obligations to provide family planning services to 
                patients consistent with Federal requirements.

                Through this order, I direct my Administration to build 
                on this progress and further strengthen and bolster 
                access to affordable, high-quality contraception. It 
                remains the policy of my Administration to support 
                access to reproductive healthcare services and to 
                protect and defend reproductive rights in the face of 
                ongoing efforts to strip Americans of their fundamental 
                freedoms.

                Sec. 2. Improving Access and Affordability Under the 
                Affordable Care Act. (a) The Secretaries of the 
                Treasury, Labor, and Health and Human Services 
                (Secretaries) shall consider issuing guidance, 
                consistent with applicable law, to further improve 
                Americans' ability to access contraception, without 
                out-of-pocket expenses, under the Affordable Care Act. 
                In doing so, the Secretaries shall consider actions 
                that would, to the greatest extent permitted by law:

(i) ensure coverage of comprehensive contraceptive care, including all 
contraceptives approved, granted, or cleared by the Food and Drug 
Administration, without cost sharing for enrollees, participants, and 
beneficiaries; and

(ii) streamline the process for patients and healthcare providers to 
request coverage, without cost sharing, of medically necessary 
contraception.

                    (b) The Secretaries shall consider additional 
                actions, as appropriate and consistent with applicable 
                law, to promote increased access to affordable over-
                the-counter contraception, including emergency 
                contraception.

                Sec. 3. Supporting Access Through Medicaid and 
                Medicare. The Secretary of Health and Human Services, 
                through the Administrator of the Centers for Medicare 
                and Medicaid Services, shall consider taking steps, as 
                appropriate and consistent with applicable law, to:

[[Page 41817]]

                    (a) expand access to affordable family planning 
                services and supplies across the Medicaid program, 
                including by identifying and disseminating best 
                practices for providing high-quality family planning 
                services and supplies, including through Medicaid-
                managed care; and
                    (b) improve coverage and payment for contraceptives 
                for Medicare beneficiaries through Medicare Advantage 
                and Medicare Part D plans.

                Sec. 4. Additional Actions to Support Contraception 
                Access. (a) To promote access to affordable, high-
                quality contraception, the Secretary of Defense, the 
                Secretary of Veterans Affairs, and the Director of the 
                Office of Personnel Management shall consider 
                additional actions, as appropriate and consistent with 
                applicable law, to:

(i) ensure, where appropriate, robust coverage of contraception under 
Federal programs;

(ii) offer technical assistance to help promote access to contraception, 
where relevant; and

(iii) educate Federal program participants and beneficiaries on how to 
access affordable, high-quality contraception, including through public 
awareness initiatives that provide timely and accurate information about 
such access.

                    (b) To promote access to affordable, high-quality 
                contraception across Federal healthcare programs and 
                relevant human services programs, including through 
                Title X clinics, HRSA-funded health centers, and the 
                Indian Health Service, the Secretary of Health and 
                Human Services shall consider taking actions, as 
                appropriate and consistent with applicable law, to:

(i) encourage all federally funded health centers, including HRSA-funded 
health centers, to expand the availability and quality of voluntary family 
planning services offered to beneficiaries;

(ii) support healthcare providers that participate in the Title X program 
through new technical assistance and training;

(iii) support access to culturally and linguistically appropriate care, 
including by developing and disseminating materials on family planning 
services available at federally funded health centers;

(iv) provide guidance on contraception-related obligations, such as 
confidentiality protections, and technical assistance resources to funding 
recipients, where relevant; and

(v) support research and data analysis to document gaps and disparities in 
access to contraception, as well as the benefits of comprehensive coverage 
for contraception and family planning services through public and private 
healthcare programs.

                    (c) The Secretary of Labor shall identify best 
                practices for making affordable, high-quality 
                contraception available to health plan enrollees, 
                participants, and beneficiaries to share with employers 
                and organizations that sponsor private health coverage.
                    (d) The Secretary of Education shall convene 
                institutions of higher education to share best 
                practices for making affordable, high-quality 
                contraception available, as well as ways to raise 
                awareness of options for accessing contraception.

                Sec. 5. General Provisions. (a) Nothing in this order 
                shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or 
the head thereof; or

(ii) the functions of the Director of the Office of Management and Budget 
relating to budgetary, administrative, or legislative proposals.

[[Page 41818]]

                    (b) This order shall be implemented consistent with 
                applicable law and subject to the availability of 
                appropriations.
                    (c) This order is not intended to, and does not, 
                create any right or benefit, substantive or procedural, 
                enforceable at law or in equity by any party against 
                the United States, its departments, agencies, or 
                entities, its officers, employees, or agents, or any 
                other person.
                
                
                    (Presidential Sig.)

                THE WHITE HOUSE,

                    June 23, 2023.

[FR Doc. 2023-13889
Filed 6-27-23; 8:45 am]
Billing code 3395-F3-P