HRSA Is Re-Competing the Panel That Decides Which Women's Preventive Services Insurers Must Cover for Free

On paper, HRSA's new women's health notice is a small grant: $1 million, one award, posted on a Friday. On November 6, 2026, the Health Resources and Services Administration released HRSA-27-072, the Women's Initiative for Screening and Health (WISH). It is a five-year cooperative agreement to update the HRSA-supported Women's Preventive Services Guidelines. Applications are due January 8, 2027, at 11:59 p.m. ET, and HRSA expects to make the award by March 1, 2027.

The dollar amount understates what the award controls. Under section 2713 of the Public Health Service Act, added by the Affordable Care Act, most private health plans created or changed after March 23, 2010 must cover the services in these Guidelines "without charging patients (no copays, deductibles, or coinsurance)." HHS estimates that about 58 million women have private coverage that includes these services. Whoever wins WISH runs the expert panels and evidence reviews that recommend what goes into the Guidelines, what stays in, and what changes. HRSA makes the final decision, but the recommendations are where every coverage change starts.

This guide covers what the award funds, what changed from the program's previous decade, who can realistically compete, and how to build an application for a contest with only one winner.

What the Award Funds

The NOFO sets out these terms:

• Instrument: one cooperative agreement from HRSA's Maternal and Child Health Bureau, Division of Women's Health. The authority is Title V, §501(a)(2) of the Social Security Act (Assistance Listing 93.110, SPRANS).
• Base funding: expected total of $1,000,000 in FY2027, with a funding range of "$0 – $1,000,000."
• Period of performance: five 12-month budget periods, March 1, 2027 through February 28, 2032. Funding in later years depends on appropriations and performance.
• Two optional supplements, up to $250,000 per year each for up to five years:
  1. Dissemination and Awareness: outreach, provider education and implementation tools, with emphasis on "rural, frontier, tribal, and other communities with limited access to preventive health services."
  2. Emerging Issues Research and Program Implementation: implementation science, pilots, and research on "emerging clinical or women's health issues."
• One application only. The base request and any supplement requests must go in the same submission. If you submit more than once, HRSA keeps only your last on-time submission. You can't win a supplement without winning the base award.
• No cost sharing, and HRSA says voluntary cost share "will not be considered during merit review."
• Page limit: 60.
• Indirect costs: your negotiated rate, or the de minimis rate of up to 15 percent of modified total direct costs.

If the full package is funded in every year, it would be worth up to about $1.5 million a year. HRSA hasn't committed to that, and the NOFO says plainly that the program "depend[s] on the appropriation of funds."

What the Winner Has to Do

The NOFO lists three sets of work.

1. Convene the coalition. This means a multidisciplinary panel of at least 10 experts. The NOFO names the types of organizations it expects at the table, including national groups representing family physicians, pediatricians, adolescent medicine, internal medicine, preventive medicine, OB-GYNs, nurse practitioners and nurse-midwives. It also requires, "at a minimum," representation of public health, primary care, chronic disease management, preventive medicine, obstetrics and gynecology, behavioral health, patients, consumer organizations, and groups reaching women with limited access to care, "including rural health organizations and providers, community-based organizations, and faith-based organizations."

2. Run the evidence reviews. The review process must follow the National Academies' standards for trustworthy guidelines. Each of the 14 current Guideline topics has three parts:

• Clinical Recommendations, which HRSA "review[s] and approve[s] for purposes of health insurance coverage without cost-sharing." This is the part with financial consequences, and the NOFO tells applicants to prioritize it.
• Implementation Considerations, which guide clinicians but don't affect coverage.
• Research Recommendations, which identify evidence gaps.

Workgroups must have at least 10 members, including methodologists. They must review USPSTF recommendations, the Bright Futures periodicity schedule and professional-society guidelines alongside new evidence. By October 1, 2028, and every year after that, the recipient has to deliver an updated evidence report, a presentation and summaries of all public comments. Every Guideline must be reviewed "at least once during the period of performance."

3. Disseminate. This includes maintaining the Well-Woman Chart, building implementation tools and running a coordinated outreach plan aimed at clinicians, health systems, insurers, educators and patients, again with an emphasis on rural, frontier and faith-based partners.

What Changed From WPSI

The NOFO describes WISH as building on "a decade of HRSA-supported guidelines developed through the Women's Preventive Services Initiative (WPSI)," and a footnote says the program was "previously titled" WPSI from 2016 to 2026. HRSA has competed the program twice since 2016. The public record shows the American College of Obstetricians and Gynecologists (ACOG) has led WPSI since it began. Over that period WPSI grew the Guidelines to their current 14 topics, which include contraception, breast and cervical cancer screening, breastfeeding services and supplies, and the well-woman visit.

Read alongside the WPSI cooperative agreements, the new NOFO differs in five ways that applicants, and especially the incumbent, should notice.

The name and the brand now belong to HRSA. The recipient must "comply with HRSA requirements governing the use of the WISH name, logo, trademarks, and other HRSA-owned intellectual property," and needs HRSA approval before releasing anything that uses that branding. HRSA must also clear all publications and public-facing products. A trademarked, agency-owned name means the program's identity stays with HRSA if the award changes hands.

The framing has moved toward chronic disease and "gold-standard" evidence. HHS says the program "advances Making America Healthy Again priorities around disease prevention and reducing rates of chronic disease," and that HRSA "aims to reduce the burden of chronic disease in women." The press release ties WISH to Executive Order 14437, "Advancing Women's Health to Improve Outcomes in All Phases of Life," signed in October 2026. Secretary Robert F. Kennedy Jr. described the goal as "preventive care grounded in gold-standard science." The chronic-disease seat on the panel is new language, and so is the emphasis on faith-based partners.

"Update or reaffirm." The NOFO repeatedly tells the recipient to "update or reaffirm" existing Guidelines. Since every Guideline must be reviewed during the five-year period, every current coverage requirement, contraception included, will go through a formal evidence review under this award. A reaffirmation is a possible outcome, and so is a revision. Either one goes to HRSA, which keeps "ongoing review and final recommendation on all program activities and processes."

HRSA is closely involved. This is a cooperative agreement, and HRSA lists its role explicitly: helping develop the plan for expert participation and public comment, consulting on "compliance with all applicable federal requirements," and reviewing activities, procedures and budget items on an ongoing basis. Applicants should plan for HRSA to be an active participant in the panel process.

Legal context. In June 2025, the Supreme Court's decision in Kennedy v. Braidwood Management upheld the ACA's preventive-services coverage mandate for USPSTF recommendations, reasoning that the Task Force is accountable to the HHS Secretary. The HRSA Guidelines were already adopted by an HHS agency, so the decision mainly confirms what WISH's structure assumes: the coalition recommends, and HHS decides.

Who Can Compete, and Who Can Win

Eligibility is very broad. It includes state, local and tribal governments, public and private universities, nonprofits with or without 501(c)(3) status, for-profit organizations and small businesses. Only individuals are excluded.

In practice, a realistic applicant needs four things before January 8:

1. A convening coalition with signed commitments. If your letters of commitment don't cover the panel categories the NOFO lists, you will lose points under "Response" (30 points) and "Resources and capabilities" (30 points).
2. Guideline methodology capacity. That means staff or partners who have run systematic reviews to NASEM standards. Evidence-based Practice Centers, academic guideline groups and large specialty societies fit.
3. A dissemination network. You need to show how you will reach clinicians in rural and frontier areas, not just at academic medical centers.
4. Readiness to deliver in about 19 months. The first annual evidence report is due October 1, 2028.

Possible applicants include the incumbent; a consortium led by primary-care or preventive-medicine societies; an academic evidence center partnered with clinical societies; or a health-policy contractor, since for-profits are eligible, that assembles its own coalition. The rewritten NOFO, with its new emphasis on chronic disease, faith-based groups and rural reach, gives a challenger a reason to try. The incumbent still has ten years of established process, and the NOFO tells the recipient to "build upon and refine the existing WISH process."

How the 100 Points Break Down

Three points of strategy follow from the rubric.

Response and Resources together are worth 60 points. The approach section must cover all three components: convening, evidence review and dissemination. It also has to show "a feasible strategy for engaging trusted partners to reach populations with limited access," including rural and frontier communities. Name those partners, include their letters, and show their reach with numbers.

Make the work plan (Attachment 1) concrete. Reviewers look for a timeline that assigns an owner to each activity, explains how stakeholders take part, and fits the budget. Build the plan backward from October 1, 2028, and include public-comment windows, which the recipient must summarize.

Impact asks about sustainability. You need a plan for how the work continues "after the period of federal funding ends," and a candid account of the challenges you expect. Funding for preventive-services guideline work has been politically unstable, and naming that risk with a mitigation plan reads better than leaving it out.

Practical Next Steps

• Register now. You need an active SAM.gov registration and a Grants.gov account. A lapsed SAM registration is the most common way strong applications miss a January deadline after the holidays.
• Watch the informational webinar. MCHB will record it and post FAQs on its open-opportunities page afterward. Questions go to wellwomancare@hrsa.gov.
• Decide about the supplements early. They require separate attachments (Attachments 8 and 9) inside your single application. The Emerging Issues supplement suits organizations with research capacity, and the Dissemination supplement suits organizations with large clinician networks.
• Collect commitment letters before mid-December. Professional societies need board or executive approval, and they slow down over the holidays.

For organizations outside the coalition, the more important date may be October 2028, when the first WISH evidence report goes to HRSA. That report will be the first concrete sign of whether the Guidelines are changing. Clinicians, insurers and advocates should plan to comment.

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