By Nina Dutta
Since the implementation of the Affordable Care Act, you may
have heard some remarkable words from your pharmacist or healthcare provider:
“There’s no co-pay.”
That’s because the ACA included a mandate for most insurance companies to fully cover FDA-approved
contraception – regardless of method or price. While there is a religious exemption for insurance provided by churches and closely-held companies, millions of insured women in the U.S. have been getting their
contraception without a co-pay for several years now. In 2013 alone, women saved
more than $1.4 billion dollars on out-of-pocket costs because of the mandate.
They’ve also taken advantage of the coverage by seeking out pricier but more
effective methods like IUDs.
Now, however, the Trump Administration is poised to remove this
coverage. A document leaked on May 31st described a plan to expand the
religious exemption so that it applies to any non-governmental employer that
wants to opt out of covering contraception due to religious or moral opposition
– meaning that nearly any employer could choose to drop coverage. (And all of
this is assuming the ACA isn’t repealed outright, anyway.)
No surprise there. Women predicted a rollback on their contraceptive access and abortion rights after
the election and have been seeking long-acting reversible contraception (LARC)
methods – many of which can outlast a presidency - in record numbers.
What is surprising
is that the Administration justified expanding the exemption by questioning
whether contraception prevents unintended pregnancies at all.
Yeah, you read that right.
Apparently, key members of the Administration missed that
day of class where many of us learned that contraception works. And the advice
from their doctors. Not to mention the last 57 years of women’s progress.
So let’s break it down for them:
Alternative Fact:
Increased usage of prescription contraception hasn’t decreased the rates of
unintended pregnancy – so we shouldn’t require insurers to cover contraception.
Reality:
Unsurprisingly, contraception does what it’s supposed to, and its increased use
has been repeatedly linked to decreases in unintended pregnancy rates since the birth control
pill was invented. In fact, a recent increase in the use of prescription contraception
between 2008 and 2012 was associated with the lowest unintended pregnancy rate in 30 years.
Alternative Fact:
Increasing access to prescription contraception doesn’t mean that women
actually use contraception more – so it’s fine to reduce access.
Reality:
Actually, a wide body of research shows that
women whose insurance covers contraception are more likely to use prescription
contraception, while women without that coverage rely more on less effective
methods like condoms and are more likely to have unintended pregnancies.
Alternative Fact:
Increased access to prescription contraception increases the teen birth rate –
so we should not trust contraception at all.
Reality: History clearly
shows that as the birth control pill became more accessible throughout the
1960s, 70s, and 80s, teen birth rates across the U.S. decreased. Modern
research shows that same effect: In the CHOICE study that took place between
2007 and 2011, St. Louis teenagers at high risk for unintended pregnancy were
given their choice of any prescription contraceptive at no cost – and they
experienced abortion and teen birth at less than half of the national
and regional rates.
It’s a scientific fact that contraception works and that better
insurance coverage helps prevent unintended pregnancies. Decreasing
contraception access by weakening the ACA’s birth control mandate can only
result in more unintended pregnancies, more unnecessary abortions, and higher healthcare costs. That’s
something that we can all agree we don’t want – regardless of religious or
moral convictions.
Nina Dutta is an
advocate for women’s health and reproductive rights and a former Obstetrics
& Gynecology researcher. She is a rising 2L at the University of Michigan
Law School and is currently a Legal Intern for Legal Voice.
Photo courtesy of Sarahmirk | Wikimedia Commons
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