Replying to my mom’s concerns about no-cost birth control

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.

While discussing birth control access and the upcoming decision on whether birth control copays will be eliminated, my mom made the following three points:

• Birth control is cheaper than the cost of a baby.
• Can’t women get birth control at free clinics?
• But taxpayers are going to have to foot the bill for other people’s birth control.

My mom is always useful for providing a mainstream, moderate voice to counter my oftentimes liberal voice (you may remember reading about her disgust at my using a menstrual cup). So if word on the street is that women just need to do a better cost-benefit analysis, find a free clinic, and stop thinking they can mooch off taxpayers to get free birth control, then it’s time to set the record straight.

Firstly, yes, birth control is undoubtedly cheaper than the cost of a child. But if cost is what’s stopping women from taking birth control, then likely women are simply risking unplanned pregnancy to spend that birth control money on other bills and expenses. It’s like if you can’t afford insurance — yes, you are well aware that the cost of renters insurance is cheaper than the cost of, say, replacing everything you own if your apartment burns to the ground, but the chances seem so slim and your money is needed for immediate expenses. When faced with immediate repercussions versus future consequences, we often focus on the immediate.

So that argument does well from a, “Well, you should have done your research,” chastising standpoint, but it doesn’t really seem to grasp that people know there are risks but simply have to choose how to allocate their limited finances. That’s why no-cost birth control — which eliminates out-of-pocket costs for women — would be such a breakthrough for birth control accessibility and unplanned pregnancy prevention.

Secondly, women can get birth control at free clinics — assuming that they are close to where they live and aren’t currently closing because of state laws aimed to shut down family-planning clinics that provide abortion services. For instance, Planned Parenthood has a free birth control program, but these programs are in danger thanks to state and federal attempts to defund Planned Parenthood. And some states only have a few of these clinics, so traveling there for free birth control would take a sizable amount of time and money.

You can go here and find a list of family-planning clinics that offer reduced but not necessarily free birth control, though these are Title X funded and could be in danger depending on legislative attempts to deny Title X funds to family-planning clinics. It’s easy enough to say, “Just go to Planned Parenthood,” but low-income women are going to run out of places to turn for affordable contraception if politicians keep trying to defund and close down these clinics. Yet another reason no-cost birth control is so important.

Thirdly, you’re already subsidizing other people’s lifestyle choices. On the list of preventive services already covered by the Patient Protection and Affordable Care Act, there are items regarding obesity, tobacco, alcohol, STIs — you could craft an argument for most of the list that your tax dollars are enabling someone else’s poor decision somewhere along the line. This also sounds like the argument some elderly people make for not wanting to pay for school levies — they have no connection to the school system so why should they pay for it? Well, because education has a greater community purpose.

And birth control serves a community purpose, too. By planning pregnancies, women (and men) can better focus on getting an education, following career goals, and ensuring that if they do want to plan a pregnancy, they are in a solid place financially and emotionally to make that decision. Healthier babies, fewer abortions, less need for government assistance, people being able to get an education and jobs — these all benefit society as a whole.

Want to urge the Department of Health and Human Services to put birth control on the list of preventive services? Sign the petition here.

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.