Some of the states, including Maryland, mandated the change shortly after passage of the Affordable Care Act, which required birth control coverage but had loopholes that still made it hard for people to get it. For instance, insurers could limit the variety of birth control pills they covered. The federal law only required that one type of all forms of contraceptives be covered with no co-payment. Lawsuits by opponents of the federal law and attempts by congressional Republicans to repeal it also have threatened the future of the federal law.