The Supreme Court Could Gut Access to Birth Control This Year

With Donald Trump back in the White House, access to contraception is, sadly, not something that people can bank on anymore — whether they know it or not. This issue didn’t get much airtime during the chaotic 2024 campaign, but birth control has been in conservatives’ crosshairs for years. And while Trump’s administration will undoubtedly attack it, he’ll likely have additional help from his appointees to the Supreme Court.

On Jan. 10, the justices agreed to hear a case, Braidwood v. Becerra, that threatens the Affordable Care Act’s insurance coverage of preventive care. A group of conservative Texas employers who object to paying for birth control and pre-exposure prophylaxis for HIV argue that the Affordable Care Act can’t require preventive services be covered without costs like copays because the panels that determine coverage are unconstitutional. Their lawyer is Jonathan Mitchell, the same right-wing attorney and former Justice Antonin Scalia clerk who wrote the Texas bounty-hunter abortion ban, S.B. 8.

A ruling for the plaintiffs could mean employers and insurers reimposing copays and deductibles, or denying birth control coverage entirely, with patients on the hook for the full price. The end of no-cost coverage requirements would ultimately result in fewer people being able to afford the contraceptive method of their choice, including IUDs. The devices alone cost hundreds of dollars, then there’s the price of the office visit for insertion. Yes, an over-the-counter birth control pill hit stores in 2024, but people deserve options and it’s not affordable for everyone.

While arguments in the case have not yet been scheduled, we can expect a hearing this spring and a decision in June.

Trump does have power to restrict birth control access, but the question is how much of it he’ll use. Project 2025 calls to end the coverage mandate of a prescription-only emergency contraception pill called Ella, which conservatives falsely claim is an abortifacient. (Birth control doesn’t end a pregnancy; it prevents pregnancy by blocking fertilization or an egg implanting. The debate over how birth control actually works is only part of the reason conservatives want to restrict it. To some, contraception is a symbol of the sexual revolution that has radically altered gender and family dynamics.) 

The Heritage Foundation-written playbook also recommends kicking trusted medical orgs off the advisory committee that determines what preventive care is covered, then having the group redo all of its existing recommendations, including on birth control. Such a revision process could affect other birth control methods beyond the morning-after pill: Religious conservatives have been trying to end mandated coverage of intrauterine devices, which they also believe cause abortions. The Supreme Court allowed some exceptions in the 2014 Hobby Lobby case, where the plaintiffs specifically opposed paying for their employees’ IUDs.

With Donald Trump back in the White House, access to contraception is, sadly, not something that people can bank on anymore — whether they know it or not.

Trump’s appointees at the Department of Health and Human Services could also amend federal regulations to allow employers and schools to claim religious or moral objections to coverage, redefine “preventive care” as not including birth control, and once again defund providers of low-cost birth control under a federal family planning program called Title X. All three strategies would reduce access to birth control, but the onerous federal rule-making process and any litigation would delay the changes from taking effect. 

Given the timing, it’s a strong possibility that the conservative justices on the Supreme Court will kick off the first nationwide rollback on contraception rights in the Trump era. 

It’s also possible that Trump is happy about that, as he may not want to appear to be directly responsible for reductions in birth control access. (He would, of course, still be indirectly responsible if any of his three Supreme Court nominees is the fifth vote to side with the Braidwood plaintiffs.) 

A reasonable person could infer this after seeing Trump’s defensive reaction to an interview where he suggested he’d make changes on birth control. Trump responded to a reporter’s question on contraception restrictions in May 2024 by saying he’d have a policy on that “very shortly.” After news outlets wrote about the interview, Trump wrote in Truth Social post: “​​I HAVE NEVER, AND WILL NEVER ADVOCATE IMPOSING RESTRICTIONS ON BIRTH CONTROL.” He also said “I DO NOT SUPPORT A BAN ON BIRTH CONTROL.” 

But as we witnessed in watching legal fights over abortion, something doesn’t have to be banned for it to be completely inaccessible. And, in fact, making it less accessible is a stepping stone to removing protections and eventually making it illegal. Lawmakers enacted abortion restrictions to test the bounds of Roe v. Wade and eventually get it overturned. It took nearly 50 years and a judicial activism network, but it worked. 

When the Supreme Court overturned Roe, Justice Clarence Thomas put a target on the legal right to use contraception: He said he believed the precedent in the 1965 case Griswold v. Connecticut was equally wrong and should be overturned. (Thomas also called to overturn the constitutional rights to same-sex intimacy and same-sex marriage.) We don’t know when we’ll see a lawsuit challenging Griswold, but we know it’s coming, and we know why. And in the short term, restrictions are on the horizon. Just remember they won’t end there.

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Susan Rinkunas is an independent journalist covering abortion, reproductive health, and politics. She is a contributing writer at Jezebel and her reporting has appeared in The Guardian, Slate, The New Republic, The Nation and more.

As a Democracy Docket contributor, Susan covers the intersection of abortion, bodily autonomy and democracy.