Evers orders taxpayer funded oral contraception to be free for Badgercare members

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On Tuesday, Wisconsin Gov. Tony Evers announced he has directed the Wisconsin Department of Health Services (DHS) to issue a standing order to ensure BadgerCare Plus members can access the new daily over-the-counter oral contraception pill, called Opill, available now with no out-of-pocket cost to them.

“As we see continued attacks on women’s reproductive freedoms here in Wisconsin and across our country, our work to ensure Wisconsinites can access the reproductive healthcare they need when they need it has never been more important,” said Evers.

“Having the new Opill on the shelves across Wisconsin will expand access to more contraception options while also making it easier for folks to get the contraception they need when it works for them. And, through the standing order I’m directing today, we’re making sure BadgerCare Plus members can access this new, reproductive care at no out-of-pocket cost to them, too—that’s a big deal, folks,” Evers added.

According to Evers, last summer, the U.S. Food and Drug Administration (FDA) approved Opill, making it the first daily oral contraceptive pill for use without a prescription. According to the manufacturer, Opill will become available at Wisconsin pharmacies starting today and over the coming weeks.

“Streamlining access to contraception for BadgerCare Plus members helps them to make their own choices about their future,” said DHS Secretary Kirsten Johnson. “We appreciate the strong partnership of our pharmacy providers to help support the health needs of their communities,” Johnson said.

BadgerCare Plus currently covers over-the-counter daily oral contraception with a prescription from a provider. While Opill is available for use without a prescription, the standing order streamlines access to this new daily over-the-counter contraception pill by:
• Serving as the prescription that enables BadgerCare Plus members to pick up Opill with no out-of-pocket costs; and
• Removing the need to schedule and attend an appointment to get a prescription to have Opill covered.
Once Opill is stocked on shelves, BadgerCare Plus members will be able to go to any Medicaid-enrolled pharmacy carrying Opill, and the pharmacist will use DHS’s standing order as the prescription, allowing the patient to receive the medication with no out-of-pocket costs.

Pursuant to both standing orders, pharmacists will submit claims to Wisconsin Medicaid for covered over-the-counter contraceptives, and DHS will work with pharmacists to implement the order statewide.