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Access Denied: Birth Control for College and Low-Income Women

Dian Harrison

Birth control is a basic health care need for some young women, a smart pregnancy prevention method for others. So why has Congress made it more difficult to access for low-income and college women?

College students and low-income women face dramatic increases in birth control pricing.

College is about survival of the fittest. Every year, students are overwhelmed by many stressors such as: peer pressure, advanced course work, securing financial aid, and balancing a healthy lifestyle. How students cope with such stressors determine whether or not they will sustain and achieve the advanced education and esteemed degrees they set out for, or if their dreams will be deferred in the process of elimination.

Female students in particular are now faced with another stressor: securing access to affordable birth control, a basic health care need that was compromised by an "accidental rewording" in the Deficit Reduction Act (DRA) of 2005.

The DRA, enacted by Congress in 2007, among other regulations, was intended to regulate pharmaceutical companies from abusing Medicaid rebates to benefit themselves and not the public. However, it inadvertently ended a 20-year mutually beneficial relationship between pharmaceutical companies and college health centers as well as other trusted family planning providers when it failed to maintain a provision that allowed these safety-net providers to purchase contraceptives at deeply discounted rates.

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As a result, safety-net providers are now forced to increase both brand name and generic birth control prescription costs, consequently eliminating affordable birth control for more than three million uninsured and underinsured college students and low-income women who simply cannot afford the extra out-of-pocket expense. To illustrate, birth control prescriptions that once cost $5 to $10 per month now range from $40 to $50 per month making access unaffordable for those living below the federal poverty line.Photo courtesy ABC NewsPhoto courtesy ABC News

It is imperative that women-whether insured or uninsured, a student or low-income-have access to affordable birth control options. Not only does birth control empower women to control their reproductive future by preventing unintended pregnancies, its other benefits include easing dysmenorrheal pain and other premenstrual symptoms, treatment of endometriosis (a condition that affects approximately five million American women), acne treatment, regulating the menstrual cycle, and controlling the menstrual flow.

Because of sound public health policies, California women are not greatly affected by the increase in birth control prices, yet campus health centers in California are subjected to the national birth control rate increases, causing a delay to affordable birth control and timely preventive health care.

Certainly California’s safety-net providers are not exempt from the increase in birth control prices; however, students and low-income women have continued access to affordable birth control and reproductive health care services through their participation in the Family Planning Access Care and Treatment (PACT) program, a Medicaid waiver program.

Implemented in 1997-1998, FPACT helped to avert an estimated 108,000 unintended pregnancies by offering family planning services to females and males who "are at risk of pregnancy or causing pregnancy." Moreover, the program helped reduce the state’s teen pregnancy rates by over 50 percent.

Undoubtedly a successful program, FPACT provides reproductive health care and education to more than 1.5 million Californians who otherwise would not qualify for coverage under other health plans. Yet even with provider support from the public and private sectors, the future of FPACT is unknown as it has been awaiting reauthorization since January 2005. If granted a permanent waiver, California could build on the success of the past decade and continue to provide students and low-income women and men with comprehensive reproductive health care, including affordable birth control.

It’s time to take action and urge our members of Congress to restore affordable birth control prices to college health centers and other trusted family planning providers. Birth control is basic health care; therefore, a woman’s option to use contraception to prevent an unintended pregnancy should not be based on her socio-economic status. It’s long overdue for FPACT to be granted a permanent waiver to ensure Californians have uninterrupted access to reproductive health care services. These are common sense policies that we should all be able to agree on because they work.

What can you do to help? Take action. Ask your Federal
Representative to support the Prevention Through Affordable Access Act (H.R.