14. Department of Health and Human Services · Notable
Require coverage of fertility awareness–based methods and supplies
Printed page 485 14. Department of Health and Human Services
“HHS should more thoroughly ensure that fertility awareness–based methods of family planning are part of women’s preventive services under the ACA. FABMs often involve costs for materials and supplies, and HHS should make clear that coverage of those items is also required.”
What has happened
- Not started
Nothing has been added to the Women's Preventive Services Guidelines about fertility awareness-based methods, and nothing clarifies that the materials and supplies they require must be covered. The only change to the Guidelines in the window is the cervical cancer screening recommendation accepted on 2026-01-05; the contraception guideline is untouched. Federal Register full text since 2025-01-20 returns one document for 'fertility awareness', an unrelated proposed rule on excepted fertility benefits. HRSA's own Guidelines page, read on 2026-09-03, shows the operative text unchanged and hedged: "instruction in fertility awareness-based methods, including the lactation amenorrhea method, **although less effective**, should be provided for women desiring an alternative method." Instruction, not supplies — the seventeen-item enumerated full range that must be covered without cost sharing contains no fertility-awareness supply. Moved-the-other-way: a dated in-window Primary document on the ask's exact object, showing it unchanged as of the page's December 2025 review. **Dating note:** the HRSA page gives a month only, so the citation takes the Federal Register date of the guideline update, 2026-01-05.
- HRSA notice: Update to the Women's Preventive Services Guidelines (accepts the WPSI cervical-cancer-screening recommendation after public comment; records that HRSA has funded WPSI cooperative agreements since 2016 and that publishing a Federal Register notice for comment is standard practice)
- HRSA-supported Women's Preventive Services Guidelines — the enumerated contraceptive full range, item (14) condoms and item (17) emergency contraception (ulipristal acetate), and fertility awareness–based methods as instruction only and 'less effective' (Date Last Reviewed: December 2025)
Research log
What was searched, and what didn’t count as evidence
Research notes
- One shared search covered the women’s preventive services asks, #1347–#1350.
- The same “fertility awareness” search came back empty for #1219 (CDC messaging); this item is the coverage-mandate limb and is measured on its own Quote.
- HHS regulatory agenda, checked 2026-09-01. Checked against the full HHS agenda on
reginfo.gov (183 active RINs in the 2026 Unified Agenda, published 2026-08-14), not the
abbreviated version the Federal Register prints. The nearest entry is recorded here. It does
not name this ask’s object, so the Status did not change: an agenda entry counts as an attempt
only when it names what the ask asks for.
- One entry looks like a hit and is not. 0938-AV94 (Amendments to Excepted Benefits, CMS-9879, NPRM 07/2026) would let employers cover certain fertility benefits as excepted benefits, “consistent with Executive Order 14216, Expanding Access to In Vitro Fertilization”. That is assisted reproduction — the opposite pole from the fertility awareness-based methods and their supplies this Quote asks to be covered. “contracept” and “fertility awareness” return 0 across all 183 entries, and HRSA’s three entries (0906-AB31, 0906-AB34, 0906-AB37) do not touch the Women’s Preventive Services Guidelines.
- Action
- expand
- Object
- fertility awareness–based methods in the women's preventive services mandate
- ID
- 1347