The Biden administration is expected to pay $65,000 after attempting in 2021 to exclude fertility awareness-based family planning methods, a form of natural family planning, from health insurance plans under the Affordable Care Act.

The faith-based legal organization Alliance Defending Freedom (ADF) announced July 27 that a federal court has ordered the Biden administration to pay $65,000 in attorneys’ fees for violating regulatory laws when it attempted to end insurance coverage for fertility awareness methods, leaving women with only coverage for contraceptive and abortifacient drugs and devices.

The U.S. Department of Health and Human Services (HHS) had in December 2021, without explanation, removed “fertility awareness-based methods” (FABM) from the list of “preventative care and screenings” covered under the Affordable Care Act. The language allowing FABM had been in place since 2016. 

Attorneys with ADF filed a lawsuit in May 2022 on behalf of Cami Jo Tice-Harouff, a Texas nurse practitioner, and her patients against HHS and its leadership. Tice-Harouff, who holds a doctorate in nursing practice and is a member of the Catholic Medical Association, instructs patients in FABM, the lawsuit said, and is reimbursed through insurance about $350-$400 each session. 

“The Biden administration can’t impose its own preferred contraceptive methods on all women without explanation and without even allowing a real public comment period, as required by law,” ADF’s Senior Counsel Julie Marie Blake said July 27. 

“[T]he successful resolution of this case benefits all women who may wish to use fertility awareness-based methods and can now keep their preferred doctor and insurance coverage.”

Fertility awareness methods enable women to track their fertile cycles by charting one or more biomarkers, such as basal body temperature, cervical mucus, and hormone levels. Among other things, couples can use this information, in line with Catholic Church teaching, to avoid or achieve pregnancy.

In late 2022, a federal court issued an order restoring fertility awareness-based family planning methods to health insurance plans nationwide under the Affordable Care Act. The Dec. 6, 2022, order of the U.S. District Court for the Eastern District of Texas, Tyler Division, restores language to requirements issued under the Affordable Care Act that “instruction in fertility awareness-based methods … should be provided for women desiring an alternative method” to hormonal birth control. The same court had in August 2022 issued an order temporarily blocking the Biden administration’s action.

In a press release about the lawsuit, the Catholic Medical Association stressed: “Women choose FABM for a variety of reasons, including the desire to avoid the use of hormones and devices, to avoid the ill side effects of other forms of birth control, and to understand one’s natural body processes consistent with religious preferences.”

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Grace Emily Stark, the editor of Natural Womanhood, a nonprofit organization dedicated to promoting fertility awareness and fertility charting as essential tools for women’s health, told CNA that unlike outdated methods such as the rhythm method, modern fertility awareness methods provide high rates of accuracy by relying on “real-time data” by tracking biomarkers that indicate when a woman can and cannot become pregnant.