Chronicles of Contraceptive Access: The No Cost of Contraception

Birth control is an essential part of health care. However, for many the full range of options have long been out of reach due to costs.  Take, for example, the IUD—one of the most effective, longest lasting methods of contraception currently available.  This method, which can protect a woman for upwards of 10 years (depending on the IUD), but can be removed at any time, used to cost a woman as much as $1,000 in out-of-pocket costs.  Much of that changed with the implementation of the Affordable Care Act (ACA), which included a contraceptive coverage provision that went into effect for most plans in January 2013 and requires that plans cover all FDA-approved methods of contraception without additional out-of-pocket costs.  Currently, it is estimated that more than 55 million women have benefited from ACA coverage of preventive services, which includes this contraceptive coverage.  

In other words, that $1,000 IUD could cost absolutely nothing other than the premiums women already pay, because now, with the ACA in place, most insurance plans are required to provide contraceptive coverage without co-pays or deductibles to all women.  Since ACA implementation and the expansion of Medicaid, the uninsured rate has dropped by one-third for women of reproductive age, and many of these women have gained access to affordable contraceptive coverage in the process.

This is all good news, isn’t it? It would be if not for a great deal of concerning discussions in Congress.  Although many in Congress are moving away from focusing on repealing the ACA to repairing it, millions of women still stand to lose access to the full range of contraceptive methods under several proposals that have been floated.  Even worse, some may lose access to affordable contraception that is critical to their ability to live life on their own terms without the worry of having an unplanned pregnancy.

Amy T., 35, of South Bend, IN previously didn’t have access to insurance; when she finally had the money to enroll in health care coverage, she was denied due to a pre-existing condition. “I was unable to get affordable birth control for many years,” she recalls. However, due to ACA, she enrolled through her state exchange and, “I was able to get birth control and choose the best one for my body.”

Amy’s story is similar to millions of women.  The ACA has made a measurable, positive impact when it comes to the costs of all methods birth control.  Just consider the following:

  • Before the ACA, women using birth control would spend between 30 and 44 percent of their total health care spending on contraceptives.  In fact, an IUD could cost as much as one month’s salary for a woman working full-time at the federal minimum wage.
  • ACA’s contraceptive coverage has saved contraceptive users an average of $250 annually in out-of-pocket spending.  In total that adds up to an estimated annual $1.4 billion in savings for oral contraceptives alone.  Women choosing IUDS and implants—the most expensive (up-front) and most effective methods of birth control—experienced an average decline of nearly 70% in their out-of-pocket costs.

“Being able to manage my reproductive health means everything,” said Bree R., 26, a graduate student living in Washington, DC. “Thanks to ACA, (my IUD) was inserted at no cost, which I wouldn’t have been able to afford, but with the ACA, it kept me under my parent’s insurance.”

But it’s not only those women enrolling through the ACA exchanges who are benefiting from the contraceptive coverage provision. Women who purchase their health insurance through employer-provided insurance are also guaranteed contraceptive coverage without co-pays. Finally, young people who previously could not get their own insurance nor stay on their parents plans also benefit from the ACA, which now allows them to remain on their parents’ plan until they are 26.

Thirty-one-year-old Stephanie B. from Columbus, OH, receives her health insurance through her job, but as she says, “ACA took my co-pay for monthly birth control from $15 a month to zero.”

To read more real life stories about how the ACA’s contraceptive coverage has greatly benefited women’s lives (or to share your story), please visit here.

Authored by: The National Campaign

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