The Biden-Harris administration on Monday proposed a rule that would require private insurers to cover over-the-counter contraceptives at no cost.

Vice President Kamala Harris, the Democratic presidential nominee, called it “the largest expansion of contraception coverage in more than a decade” as she works to put reproductive health and women’s issues front and center in her battle with former President Donald Trump.

The Affordable Care Act, known as Obamacare, directs most plans to cover contraceptives at no extra cost. But insurers often require a prescription if enrollees want to acquire over-the-counter contraceptives without cost-sharing.

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The proposed rule would allow women to obtain those drugs without a prescription and at no cost, extending access to medications such as Plan B emergency contraceptives and Opill, the first over-the-counter oral contraceptive approved for use in the U.S.

The administration said the rule could impact up to 52 million women of reproductive age.

It is proposing the rule roughly two weeks before Election Day. Democrats are making abortion access and contraception a cornerstone of their campaign because of the 2022 Supreme Court ruling that repealed the nationwide right to abortion, handing the issue to the states.

They say Republicans won’t stop at abortion, pointing to proposed bills to ban abortion at a fixed number of weeks. Earlier this year, an Alabama ruling briefly threatened access to in vitro fertilization procedures.

“While we fight to protect and expand health care, extremist so-called leaders are attacking reproductive freedom at every turn,” Ms. Harris said Monday. “Republicans in Congress have repeatedly blocked legislation to protect the right to contraception across the country. They have also consistently refused to protect access to IVF, and continue to propose national abortion bans.”

Mr. Trump and other Republicans say the Democrats are the ones being extreme, allowing abortion in some instances through the duration of a pregnancy instead of proposing the type of limits that Americans support in polling.

Mr. Trump says the federal government should pay for IVF treatments to help families grow. He’s defended his appointment of pro-life justices, saying the decision to overturn Roe v. Wade allowed each state to debate the abortion issue.

“Through the genius and heart and strength of six Supreme Court justices, we were able to do that,” he said at the September presidential debate. “I believe in the exceptions for rape, incest and life of the mother. I believe strongly in it. Ronald Reagan did also.”