The Affordable Care Act has undeniably improved women’s ability to receive preventive care that includes contraception. Insured women are now able to have any FDA-approved birth control provided to them at no cost as part of their preventive health care. Access to contraception has been shown time and again to improve the lives of women, their children, and their families by allowing them to plan and space pregnancies, decreasing maternal and infant mortality and also increasing their economic stability.
Some states are taking steps to make birth control less expensive and more convenient to obtain!
The Affordable Care Act has also undeniably opened up a Pandora’s box of contraception-related issues.
The American Congress of Obstetricians and Gynecologists (ACOG) states that “contraception is an essential part of preventive care and all women should have unhindered and affordable access to any FDA approved contraceptive.” In their yearly report, “Access to Contraception,” they advocate 18 recommendations, which include:
- over-the-counter access to oral contraceptives that is accompanied by insurance coverage or some other cost support
- payment coverage for 3- to 13-month supplies of birth control to improve contraceptive continuation
In the United States, statistics show that half of all pregnancies are unintended. A recent study has shown that if women who were at risk for unintended pregnancy were able to easily access effective birth control (such as the Pill) at low cost and without a prescription, their rate of unintended pregnancy would decrease significantly.
Currently, most insurance companies only allow women to get 28 days’ worth of birth control at a time, whether the doctor approved larger supplies or not. Since birth control pills depend on uninterrupted use to provide contraceptive coverage, only being able to obtain a one-month supply at a time could disrupt continuation of contraceptive coverage, especially for women who do not live close to a pharmacy. The problem could be solved if people could obtain up to a year’s supply of contraception at a time, allowing them to store their birth control at home and take it consistently, with no interruptions.
Slowly, legislators are starting to address this problem. Oregon Gov. Kate Brown just signed a bill requiring insurers to cover birth control for 12 months at a time. After requiring the first prescription filling of a 3-month supply, women thereafter may get a 12-month supply. Bipartisan support of this bill was driven by the belief that improved access to contraception should decrease unintended pregnancies and promote more consistent use. Washington, D.C., legislators are also considering requiring insurance companies to authorize 12-month supplies of birth control for consumers.
Oregon is now considering another bill that would allow pharmacists to write and fill a prescription for birth control pills after a woman takes a self-administered risk-screening test. California is a step ahead. After passing SB 493 in 2013, the law is finally taking effect this year. Pharmacists are going to be providing more primary health care duties, such as ordering and interpreting lab tests, administering vaccinations, and writing prescriptions for birth control. Pharmacy education has included high levels of direct patient care in recent years, but laws have been slow to utilize their abilities. Pharmacists are one of the most accessible health care providers out there, and these changes are overdue.
Now looming on the horizon is legislation that may make birth control pills available over the counter. But at what cost — literally?
Republican senators Cory Gardner of Colorado and Kelly Ayotte of New Hampshire introduced legislation to make birth control pills available over the counter. They want the government to allow incentives for drug companies to provide these over-the-counter pills. Planned Parenthood and many other groups condemned this legislation because it did nothing to address the cost — just as one’s insurance company will not pay for non-prescription medication purchased at a local drugstore, the Republicans’ plan would shift the cost for birth control back to the user. Without insurance coverage, costs of these pills could skyrocket — and access would not be improved because fewer women would be able to afford them.
Sen. Patty Murray (D-Washington) has just introduced the Affordability Is Access Act, which will require insurers to cover birth control pills even if they are offered over the counter. Planned Parenthood and ACOG have come out in support of her plan. This discussion will intensify in the coming year, especially as we get closer to an election of a new president. Stay tuned!
Planned Parenthood health care providers can counsel you on the full range of contraceptive options available. Additionally, if paying for birth control is a financial hardship, you may qualify for funding under Title X, which could also allow you to pick up a year’s worth of birth control pills at one visit. New patients might be authorized for a smaller supply of birth control pills, just to make sure there are no adverse side effects — but, once established on a pill that works for you, it is possible to get a year’s supply at one visit. Call your local Planned Parenthood health center for an appointment!
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