The Patient Protection and Affordable Care Act (PPACA), signed into law on March 23, 2010 by President Obama, served as a major overhaul to the health insurance industry and established preventative services as a top priority. The PPACA requires certain preventative health services to be provided by new insurance plans at no cost to those covered. Among these preventative measures are a range FDA-approved contraceptives, including intrauterine devices, hormonal and barrier methods, emergency contraception and sterilization. Contraception must be provided under insurance policies provided by an individual’s educational institution or their employer.

Although many states had contraception mandates for insurers prior to the Act’s passing, the contraception mandate of the PPACA has proven to be controversial. While the Act was widely supported by progressive organizations such as Planned Parenthood, many conservative and religious organizations claimed that it violated religious liberty. In response to complaints from such organizations, the Obama administration proposed changes to the legislation. In its final version, the PPACA mandate does not apply to religious organizations, such as churches, mosques and synagogues. However, businesses owned or operated by religious institutions, including hospitals and educational institutions, are not exempt from the mandate. Insurance plans that were in place at the time the PPACA was enacted are permitted to continue without following the contraception mandate. However, this will likely change in time and any significant changes to these plans will cause the contraceptive mandate to apply.