It's time to repave the bumpy road to birth control access
This blog was submitted to the National Women’s Law Center and Planned Parenthood’s Birth Control Blog Carnival (BCBC) — view all the BCBC posts here.
If the obstacles to birth control accessibility were like potholes in the road, things like social stigma and conscience clauses would be cracks compared to the sinkhole that financial barriers are to women seeking contraception. A great help to smooth this road to accessibility would be its inclusion in preventive services under the Patient Protection and Affordable Care Act (PPACA), a move that would mean women no longer need to pay copays for birth control.
I actually used to think copays weren't so bad -- I was on my dad's insurance plan in college, and I was prescribed a birth control that had a generic, $5 form. Five bucks every month? Even as a college student that was affordable. Then I graduated, got dropped from my dad's insurance plan, and to boot my OB/GYN was concerned about the brand I was taking. My periods could be lighter, shorter, why don't I try something new?
Sure, I thought -- what could be bad about that? And then in addition to my prescription, I got a coupon to use at the pharmacy. You know your birth control is expensive when your OB/GYN hands you a card that will cap your birth control copay. It cost me $24 for this brand, which didn't have a generic form. This pill had too many ill side effects, so I got switched to another no-generic brand that cost $35 per month. Somehow, the cost of my birth control managed to increase 700 percent in less than a year.
I was lucky in that, despite a three-month bout of unemployment, I never had to go without birth control to pay other bills or expenses. But that isn't the case for everyone -- in fact, the cost of this preventive health measure actually prevents a lot of women from either starting to take or regularly taking birth control because of high copays.
Some people want to argue about the merits of calling birth control "preventive," that it implies pregnancy is a disease -- those arguments are nothing but games of semantics that, by the way, ignore that some items already included as preventive services under PPACA are not directly preventing diseases, either. Birth control is the epitome of preventive -- it prevents unplanned pregnancies, prevents the risks then associated with unplanned pregnancies because women don't know they're pregnant, and inevitably prevents abortions.
I've had experience with the other accessibility roadblocks, too -- a friend of mine couldn't get a prescription from any doctor in her doctor's office because one of the doctors had religious objections to birth control (and for some reason it was OK for the entire office then to deny writing the prescriptions because of this?); I have felt awkward asking for birth control because I was young and felt my OB/GYN would stun me with judgmental eyes. But to avoid or breakthrough these roadblocks just to be met with a copay that could exceed $50 every month? A copay that could equal or surpass, say, your electric bill? A copay that for other preventive health services doesn't exist? It's like staring at the road wondering, "Why are they filling all these other potholes and just ignoring this huge one in the middle of the road?"
And it's essential for women's health that this pothole be filled because a different one is rapidly growing, courtesy of politicians who have set their sights on attacking women's health. Their attempts to defund organizations like Planned Parenthood -- which overwhelmingly works to provide low-income women with affordable contraception and health services like breast cancer screenings, pap tests, and STI testing -- serve as the latest obstacle to affordable birth control and healthcare. In this atmosphere, a detour in the form of eliminated copays is welcome and necessary -- Jezebel's Erin Gloria Ryan put it best when she said that this possibility seems like "a glimmer of hope that maybe the government doesn't actually hate us after all."
The Institute of Medicine has recommended to Department of Health and Services Secretary Kathleen Sebelius that birth control be included as a preventive health service, and I really, really, sincerely hope that it is. Cost is a huge roadblock for people who want to take but can't always afford preventive measures, so lifting this barrier would be a monumental for women's healthcare and contraceptive access.
Want to urge the Department of Health and Human Services to accept the IOM's recommendations? Sign the petition here.