California Expands Equitable Access to Over-the-Counter Birth Control for Medi-Cal Enrollees with Governor Newsom’s Signature of AB 50

Sacramento, CA – Today, on World Contraception Day, Governor Gavin Newsom signed AB 50 — the Equitable Birth Control Access Act — into law, ensuring Californians enrolled in Medi-Cal have equitable access to over-the-counter (OTC) birth control methods, including the first-ever FDA-approved OTC birth control pill, Opill, without out-of-pocket costs or unnecessary barriers. AB 50 is a key step to expanding access to birth control, as demonstrated by new evidence that OTC pills have meaningfully increased use among people facing the greatest barriers to care. The bill contains an urgency clause, allowing it to take effect immediately.

AB 50 was authored by Assemblymember Mia Bonta and co-sponsored by Essential Access Health, Birth Control Pharmacist, and National Health Law Program (NHeLP).

“This critical bill removes a systemic barrier that has denied Californians with Medi-Cal coverage from the same over-the-counter birth control access as those with private insurance. No one should face barriers to birth control—especially when it is available off the shelf and without a prescription at local pharmacies. This needed fix comes at a time when reproductive health care and providers are under attack and offers a new option and pathway to contraception for Medi-Cal enrollees,” said Amy Moy, Co-CEO of Essential Access Health. “We thank Assemblymember Bonta for her leadership, applaud the Legislature’s strong bipartisan support, and appreciate Governor Newsom signing AB 50 into law. Essential Access Health has co-sponsored every major birth control access law in California over the past 15 years—and we will not stop until everyone can get the contraception they need, when and where they need it.”

“Accessing reproductive care should never depend on your income or type of insurance,” said Assemblymember Mia Bonta. "AB 50 ensures that Medi-Cal recipients can access over-the-counter birth control just like those with private insurance. As Chair of the Assembly Health Committee, I remain committed to expanding California’s leadership in reproductive justice, especially as a federal administration seeks to roll back reproductive rights and leave our daughters with fewer freedoms than their mothers had.” 

In California, public and private health insurance are required to cover OTC birth control without cost-sharing or a prescription. However, since federal law requires a prescription for Medi-Cal coverage of outpatient medications, to date Medi-Cal enrollees accessing OTC birth control have had to navigate the same procedures as if they were obtaining a prescription-only contraceptive – including finding a specially trained pharmacist, completing a self-screening questionnaire, and receiving counseling – just to obtain contraception already approved for OTC use. AB 50 eliminates these burdens by allowing pharmacists to furnish OTC birth control for Medi-Cal enrollees without those procedures, ensuring Californians enrolled in Medi-Cal have the same access to OTC birth control as those with private insurance.

"California continues to break down barriers to birth control," said Dr. Sally Rafie, pharmacist and founder of Birth Control Pharmacist. "This new law recognizes that pharmacists are uniquely positioned to connect people with the birth control method that’s right for them—whether prescription or over-the-counter—with insurance coverage and no out-of-pocket costs. Thanks to the leadership of Assemblymember Bonta and Governor Newsom, Californians will now be able to walk into a pharmacy and leave with the contraception they need. Birth Control Pharmacist is proud to have co-sponsored AB 50 with Essential Access Health and the National Health Law Program to help make reproductive freedom a reality for all."   

“This law advances health equity by making it easier for people, including those enrolled in Medi-Cal, to access over-the-counter contraceptives,” said Christina Piecora, Senior Policy Analyst at the National Health Law Program. “At a time of provider shortages and ongoing attacks on sexual and reproductive health care, increasing access to contraception is crucial. The National Health Law Program is proud to have co-sponsored AB 50 with our partners at Essential Access Health and Birth Control Pharmacist. We commend Assemblymember Bonta for her leadership and for being a long-standing advocate for advancing access to sexual and reproductive health care.”

A new nationwide study published in JAMA Network found that OTC birth control has already become a critical source of access in the U.S., particularly among communities who face the greatest barriers to care, including adolescents, people of color, Medicaid enrollees, those without insurance, and rural residents. Researchers documented a 31.8 percentage point increase in people who shifted from using no birth control to using the OTC pill. AB 50 will strengthen this critical pathway to care and ensure Medi-Cal enrollees have equitable, affordable, and timely access to the birth control they want and need. 

Essential Access Health (Essential Access) is a trusted leader on birth control coverage and access policies. In addition to sponsoring the Contraceptive Equity Act of 2022, Essential Access previously sponsored legislation that requires health plans to cover a 12-month supply of self-administered birth control, requires plans to provide access to the full range of FDA-approved birth control methods without cost-sharing, delays or denials, and allows registered nurses to dispense hormonal birth control. Essential Access has also administered the federal family planning program Title X in California since 1970 when the program was established and in Hawai’i since 2022, and currently distributes funding to and supports nearly 350 health care delivery sites across both states.