Access to Birth Control, Under the Next President

Can I get a prescription for birth control from a doctor? Can I get contraception from a Title X program? Do I know how to use it? Some answers for you - depending upon either a McCain or an Obama administration.

It’s hard to measure support
for access to contraception for two reasons — "access" and "contraception" both denote very
broad categories.  Contraception is everything from condoms to
birth control pills to sterilization, and access points range from non-profit
distribution to convenience stores to doctor’s offices.  Do we
consider someone’s access more or less limited if they can get birth
control pills from Planned Parenthood but the condoms at the grocery
store are locked up after 10pm, which is when they discover they need
them?  I can’t answer that question for you, because it’s the
very definition of subjective, but I can point out five basic areas where access meets contraception and how the two candidates for
President approach them.  As far as I know, both McCain and Obama
have not registered an opinion on whether or not it’s completely lame
of your grocery store to require you to summon a clerk to open the condom
display.   

So here’s a rundown of five
basic questions people ask of themselves when looking to access contraception,
and answers Senators McCain and Obama have given through votes and campaign
platforms. 

Can I get a prescription
from a doctor? 
The chance of getting a prescription from a
doctor is 99% based on whether or not you can see one, and that, for
most people, depends on if you have insurance that covers this. 
Currently, 16% of Americans
don’t have this basic opportunity.
 
Both candidates claim they have plans that will get coverage to most
Americans and lower costs, but these are claims that bear closer examination.   

The McCain proposal is all
about the free market.  The campaign claims that getting people
out of employer-provided health care and making them free agents on
the market will lower prices.  To reach this goal, they intend to tax employer-provided
benefits, with the hope that this encourages people to give up that
coverage.
 
Less people using employer-provided benefits is extremely unlikely to
have the results promised by McCain.  We only have so many uninsured
people right now because they don’t have employer-provided insurance,
and therefore can’t use their employers’ bargaining power to get
coverage despite pre-existing conditions.  At best, we will see
people just paying more for health care under the McCain plan, but at
worst we’ll see the number of uninsured go up, meaning that more women
will have to turn to non-profits or government programs for birth control
access.  Or go without.   

The Obama proposal takes another
tack, responding to the fact that most Americans who are uninsured are
so because they don’t have access to employer-provided health care. 
People who already have employer-provided health care don’t have to
change a thing or pay more for it.  People who aren’t able to
access that kind of health care will be extended the opportunity to
buy into a national health plan that will have guaranteed eligibility,
so you won’t need to have an employer’s power backing you up so
you can get insurance.  For people who don’t already qualify
for Medicaid or SCHIP but still need assistance paying for health insurance,
there will be subsidies to help them out. 

By addressing the main cause
of insurance gaps—lack of access to employer-provided insurance—the
Obama plan will be far likelier to increase the number of Americans
who have coverage. 

Can I get contraceptives
from non-profits or government programs?
  For people who go
to Planned Parenthood or some other non-profits that receive government
funds for their health care, this election might also influence their
bottom line ability to receive care.  The main thing you’re wanting
to look at in this department is the voting record on Title X and other
family planning programs.  On this issue, the two candidates strongly
differ.  McCain attempted to end
Title X funding that pays for contraception programs, as well as other
women’s health care.
 
Obama is a strong supporter of Title X funding, which causes much
consternation amongst anti-choicers.
 
If you get your contraception—prescribed or over the counter at a
discount—or any kind of health care from Planned Parenthood, then
this is the funding debate that pertains to you.  

Obama has also sought ways
to expand the ways in which the government can make it easier for you to
get contraception, by co-sponsoring the Prevention First
Act
. This legislation would
increase Title X spending, but also make it easier to get emergency
contraception if you’re sexually assaulted. 

Can I get contraception
from my pharmacy? 
Under Bush, as you no doubt know by now,
Health and Human Services (HHS) tried to expand
the right of health care workers to refuse to give you contraception
by allowing individuals to decide
that they just believe that contraception is abortion, facts be damned. 
Refusal clauses are another brain child of the religious right. 
They figure if they can’t get the government to deny you contraception,
they’ll get vigilante pharmacists to do it instead.  This HHS
controversy is the first time the issue has really risen to the national
level, and so we have a fairly cut-and-dry source to look for which Senators
will fight against refusal clauses and which won’t— Hillary Clinton’s
letter of protest against the HHS for this abuse
of power.
 
Barack Obama was one of 28 Senators who signed this.  John McCain did not.  

Do I know how to use this
stuff?
  Right now, the federal government doesn’t pay for
the education of adolescents in the art of not getting knocked up or
catching some nasty STI, but instead backs abstinence-only "education",
otherwise known as, "Maybe you’ll figure it out after the first
3 unintended pregnancies or STI infections" non-education. McCain considers
himself a supporter of abstinence-only programs.
  Barack Obama has tried to introduce
comprehensive sex education in two separate ways.  First was the Prevention Through
Affordable Access Act
,
which would support comprehensive sex education programs.  Then
there was the Lautenberg/Menendez amendment to Child Custody Protection
Act to reduce teen pregnancy
through education.
Obama voted for
this amendment, and McCain voted against it.
 

Can I afford this? 
For a lot of women who use hormonal contraception, affordability depends
on whether or not their health care plans cover contraception. 
For college-aged women, this often means using discounted pills through
student health services, a discount that disappeared after budgetary
changes to reduce the deficit in 2005.  To restore access to inexpensive
contraception, Barack Obama introduced the Prevention Through
Affordable Access Act

in 2007, which, if it passes, will rectify the problem and reduce the
price of birth control pills on campus. 

Women who rely on insurance
co-payment to make their birth control more affordable hit a major obstacle
when they have insurance companies that won’t pay for it, but will
pay for other drugs like Viagra.  McCain voted against a bill that
would require equal coverage for women, and asked about it by
a reporter for the L.A. Times, tried to get out of the question.
Obama, in contrast, championed the Prevention First
Act,
which would
ensure that insurance companies treat birth control pills like they
do other drugs, instead of giving them higher co-pays.