Not So Jagged Little Pill: Why Women Need No-Cost Birth Control

Originally posted at The Opinioness of the World. Part of the “We’ve Got You Covered” Birth Control Blog Carnival.

Birth control free of co-pays!  In a landmark decision on Wednesday, the National Academy of Sciences’ Institute of Medicine (IOM) recommended insurance plans offer contraceptives and other preventive services, free of charge under the new health care law that went into effect last September.  With half of all pregnancies unplanned, greater access to birth control would be a huge boon for many women.

In the past, other review panels and task forces have ignored women’s health and “paid less attention to gender-specific recommendations.”  Secretary of Health and Human Services (HHS) Kathleen Sebelius requested the review which examined data on women’s health.  According to the NY Times:

“In explaining its recommendation for free contraceptives, the panel noted that nearly half of all pregnancies in the United States are unintended, and about 40 percent of those end in abortion. Studies show that cost is a major barrier to regular use of contraceptives for low-income and young women.”

Cost is a huge factor in obtaining healthcare.  According to the National Women’s Law Center, “Women are more likely than men to avoid needed health care, including preventive care, because of cost.”  Many women will forgo going to the doctor, delay routine exams or screenings due to the price and avoid prescriptions (including birth control) with co-pays, especially women with low incomes.

My birth control pills have always been about $33 a month.  Now, it might not seem like a lot but it adds up.  That’s $396 a year.  Using NARAL Pro-Choice America’s Facebook app, “No-Cost BC4ME,” I found out at my age and with no kids, I could save $4,356 over my lifetime for the pill; the app states that’s enough to “fund 10 years of education for a child in a developing country.”  In addition to the pill, the app covers costs for other types of birth control (patch, implant, shot, vaginal ring, diaphragm, IUD, cervical cap).  Thinking about my own finances for a moment, that also equals 4 months of my rent, 11 of my laptop computers, 2 years of my monthly student loan payments, or groceries free for about a year. If I hadn’t had to pay co-pays from the time I was 18, I would save $10, 296!  For women living paycheck to paycheck, who have to decide between paying for rent, groceries or diapers, having to pay $33 can be a huge barrier to access contraception.

Most women’s fertility spans approximately 30 years.  And “for approximately three-quarters of her reproductive life, the average woman is trying to postpone or avoid pregnancy.”  Unintended pregnancies can complicate or worsen “a pre-existing health condition such as diabetes, hypertension, reflux esophagitis, lower extremity or lumbar arthritis, and coronary artery disease.”  Contraception goes beyond just preventing pregnancies, yielding additional health benefits to women.  “Oral contraceptives…lower rates of pelvic inflammatory disease, cancers of the ovary and endometrium, recurrent ovarian cysts, benign breast cysts, and fibroadenomas.”  But the recommendations don’t just stop at birth control.  They would also include pap smears, cervical cancer screenings, gestational diabetes screenings, access to breast pumps, HIV testings and counseling for domestic violence.  These measures would greatly enhance the health of women, particularly Latinas.

Conservative Republicans have been hard at work at the federal and state level trying to thwart abortion access and defund Planned Parenthood and family planning programs.  According to the Guttmacher Institute, 18 states have a specific line item in their state budgets reserved for family planning funding.  8 states (Florida, Georgia, Michigan, Minnesota, New Hampshire, Texas, Washington and Wisconsin) slashed their budgets for family planning programs, usually in alignment with cuts to other health programs.  Montana eliminated family planning funding from their budget all together.  Legislators have also been targeting abortion providers like never before.  5 states (Colorado, Indiana, Ohio, Texas and Wisconsin) restrict funding to family planning providers.”  Indiana and Wisconsin recently starting prohibiting clinics and agencies that provide abortion services (or even referrals in the case of Wisconsin) from receiving state funding for family planning.  Luckily in Indiana, a federal district court blocked this bullshit legislation.  Colorado, Ohio and Texas require “agencies that receive funding – either state family planning funds or federal block grant allotments—through a state agency to be separate from agencies that provide abortion services.”  Additionally, North Carolina banned Planned Parenthood from receiving state funding, Kansas “limits the distribution of Title X funds to health departments, hospitals and community health centers; other types of family planning providers are not eligible,” and Texas gives priority of family planning funding, including Title X funding, “to health departments, community health centers and hospitals.”

In the ongoing barrage on reproductive rights, a few bright spots have appeared on the horizon.  9 (Colorado, Connecticut, Delaware, Illinois, Kansas, Massachusetts, Maine, New York and Pennsylvania) of the 18 states that delineate a specific budget line item for family planning “avoided major cuts.”  Maryland and Washington expanded Medicaid eligibility for family planning.  And the recent IOM recommendations add to the burgeoning good news.

While the recommendations aren’t set in stone yet, it’s a huge step in the right direction.  We live in a society that rarely supports preventive measures and programs.  As Maria Elena Perez, at the National Latina Institute for Reproductive Health (NLIRH), astutely asserted at RH Reality Check:

“It’s a remarkably different set of priorities to make being healthy the goal of healthcare, rather than simply treating illness.”

Healthcare is a human right, which includes birth control, family planning and reproductive services.  In a supposedly democratic society that preaches liberty and justice for all, we live in a country facing massive social inequities, particularly for those affected by socioeconomic status.  But money shouldn’t be a factor in people acquiring the medical care they need.  Whether choosing to have children or not, when people can control their reproduction, they lead healthier and happier lives.  It’s time we empower people to have safe, affordable healthcare and choose what’s right for them.

Read all the posts participating in the National Women’s Law Center and Planned Parenthood “We’ve Got You Covered” Birth Control Blog Carnival and follow the #BCBC tweets!