The birth control coverage mandate: our work isn’t done

Crossposted at Of Means and Ends.

A few years ago, I went to the doctor about a pain in my leg that was so intense it would wake me in the middle of the night. Tests revealed that it was a blood clot, and with no other risk factors my doctor determined it was caused by birth control pills. I had to stop taking them immediately, and thankfully a combination of medicine and stopping the pills cleared it up. But it left me with very limited effective birth control options as any return to hormonal birth control methods could potentially be life-threatening. Despite a clear medical reason for switching to an IUD, I still had to wade through obstacles thrown up by my insurance company, and my doctor wouldn’t even give me an appointment until it was clear how much my insurance would cover. I was lucky to be able to get access to the care I needed eventually, but for a lot of women it can be even more challenging, time consuming and costly.

With all the handwringing and hyperbole around the Affordable Care Act’s contraception mandate, you would think the government is handing out free birth control pills on every street corner (though some people apparently think you can get all the birth control you need at 7-11). You would think that the inconveniences I encountered would be a thing of the past. The fact is, while the ACA will make contraception access easier for a lot of women, there are still too many loopholes.

The California Family Health Council explains:

The Women’s Health Amendment in the federal health reform law (the Affordable Care Act), requires most health insurance carriers to cover the full range of FDA-approved birth control methods and voluntary sterilization services, without any out-of-pocket costs for female enrollees and dependents. While this requirement was a significant step forward, related federal regulations allowed for “reasonable medical management techniques” to be applied in the context of contraceptive coverage, but did not include a definition of the term. This lack of clarity has led to inadequate and inconsistent implementation of the contraceptive coverage provision. The result is women across the nation and state being denied the birth control method of their choice or having to wait or pay out of pocket for the method prescribed by their health care provider.

That opaque bureaucratic lingo might not sound like much on the surface, but it means that insurance companies can stand between women and their doctors in deciding what affordable birth control methods they have access to.

Of course, politicians, corporations and Supreme Court justices are sticking their noses in as well. The Supreme Court is deliberating on the case brought by Hobby Lobby, a corporation that claims that covering some forms of contraception violates its religious beliefs. Their objections to emergency contraception and IUDs are not based on any kind of science, but a ruling could set a dangerous precedent in creating different classes of contraception (not to mention so many other horrible precedents around corporate personhood and religious freedom).

Insurance companies and corporations like Hobby Lobby could make the most effective birth control methods for women unaffordable or inaccessible. California is leading the way in tightening up these loopholes and making sure the ACA truly meets the needs of California women.

Recognizing that birth control plays an essential role in the health and well being of individuals and their families, Senator Holly J. Mitchell [D-26] of Los Angeles has introduced SB 1053 – the Contraceptive Coverage Equity Act.

Building on current state and federal law, this bill seeks to improve access to the full range of FDA-approved birth control methods by assuring that all Californians with a health insurance plan can obtain contraception without restrictions, delays, or out of pocket costs. The bill is co-sponsored by California Family Health Council and the National Health Law Program.

The Senate’s Health Committee heard the bill last week.

Usually if a state legislature’s actions on reproductive rights make the national news, it’s because they’ve done something horrendous. It’s important that we share the important work activists are doing to proactively expand access to reproductive health services. It provides much needed energy and encouragement to activists working in what is often a bleak political landscape, and can serve as a model for future victories around the country.