Got Birth Control? Americans Overwhelmingly Support Eliminating Co-Pays for Contraception

Jodi Jacobson

A large majority of American voters believe that insurers should include birth control as a fully covered preventive health service according to a new survey.

A large majority of American voters believes that insurers should include birth control as a fully covered preventive health service, along with colonoscopies, annual health checkups, prenatal care and other forms of primary preventive care, according to a new survey.  The Patient Protection and Affordable Care Act mandates that by 2014 all health care plans cover basic preventive services free of out-of-pocket costs, such as co-pays.  And Americans want birth control to be part of the package.

The survey of 1,147 voters, conducted by Hart Research and commissioned by Planned Parenthood Action Fund “found overwhelming and widespread public support for national policies that would provide prescription birth control approved by the U.S. Food and Drug Administration (FDA) at no cost to all women with health insurance,” said Planned Parenthood.

Nearly three-fourths (71 percent) of voters agreed that the birth control pill and other forms of prescription contraceptive methods should be made available without co-pays.

Eighty-one percent of all female voters participating in the survey want birth control covered, including 72 percent of Republican women voters, 77 percent of Catholic women voters, and 85 percent of female voters ages 18 to 34.  Sixty percent of male voters agreed that birth control should be covered under the umbrella of basic preventive care.

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The high share of young female voters supporting full coverage of birth control is no surprise.  The survey found that one in three women voters (34 percent) have struggled with the cost of prescription birth control at some point in their lives. For young adult women, who are most likely to experience an unintended pregnancy, more than half (55 percent) have experienced difficulty affording to buy a consistent supply of birth control.

Out-of-pocket costs for birth control can be prohibitively expensive for many women, especially those with low-incomes. The high price of birth control can result in women using birth control inconsistently or not at all, often leading to unintended pregnancies. Co-pays for birth control pills typically range from $15 to $50 a month, and co-pays and other out-of-pocket expenses for long-term contraception, such as the IUD, cost significantly more upfront. 

Data released by the United States Census Bureau in December revealed that women have been hardest hit by the recession, and the poverty rate among women rose to 13.9 percent last year, the highest rate in 15 years. Not surprisingly, the Hart/PPAF survey found, that the costs of birth control were least affordable for low-income women already struggling with basic needs.  The survey found that 57 percent of young Latina women ages 18 to 34 have struggled with the cost of prescription birth control, and 54 percent of young African-American in the same age range have struggled with these costs. Inability to afford birth control is a major factor in high rates of unintended pregnancy among adolescents and young adults of all races.

Economic stress also often changes decisions about the number and spacing of children couples want. The Guttmacher Institute found that because of current economic concerns, nearly half of women surveyed want to delay pregnancy or limit the number of children they have—and for about half of these women, the recession has heightened the focus on effective contraceptive use. 

According to Guttmacher, bleak new data from the United States Census Bureau released in September:

[C]onfirm[ed] previous Guttmacher research on the severe impact of the recession. In 2009, we documented that because of economic hardship, nearly half of low- and middle-income women wanted to delay pregnancy or limit the number of children they have, but that many had to skimp on their contraceptive use—or forgo it entirely—to save money. We also found that publicly funded family planning providers were struggling to meet a growing need for subsidized contraceptive care, even as they had to make do with fewer resources.

Translation: Today, the basic costs of health care and prescription drugs are much higher, and the ability of many women, including young women, to access primary care is increasingly limited. Filling the gap between the need for contraceptive methods and the ability to access these methods makes sense socially and economically (reduction in unintended pregnancies, teen pregnancies and abortions), and in terms of health.

“At Planned Parenthood, we see too many women choosing between birth control and basics like rent, tuition and childcare,” said Cecile Richards, president of the Planned Parenthood Federation of America. 

“Because our country leads the industrialized world in unintended and teen pregnancy, prescription birth control must be made available at no cost,”  “Making birth control available at no cost makes it possible for women to use the method that works best for them and will reduce the number of unintended pregnancies in America.”

“Fully covering prescription birth control makes medical sense, because doing so would help to reduce the number of unintended pregnancies and would help to keep women and children healthy,” said Dr. Hal Lawrence, Vice President for Practice Activities, American Congress of Obstetricians and Gynecologists, at a press briefing today.

“Women whose pregnancies are unintended are less likely to get prenatal care and are at greater risk for conditions such as premature and low-birth-weight babies.”

Voters, it appears, get these issues intuitively:

As part of the Affordable Care Act, new health insurance plans are required to cover women’s preventive health care services with no co-pays to their members. The Women’s Health Amendment was included in the final legislation as a way to address gaps in women’s health care, and the law leaves it to the U.S. Department of Health and Human Services (HHS) to define what specific preventive benefits will be covered. HHS is expected to release a decision by August 2011 regarding what additional benefits will be covered.

Meanwhile, in a political climate in which virtually every aspect of women’s basic reproductive and sexual health needs have come under attack, advocates are not leaving anything to chance. Planned Parenthood has launched Birth Control Matters – an information and action site intended to ensure that HHS requires insurers to make no-cost prescription birth control available “so that all women can use the method that works best for them and to reduce the number of unintended pregnancies.”

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