The birth control benefit — a provision of the Affordable Care Act providing health insurance coverage of birth control with no co-pay— did not fall from the sky and land on the doorstep of the White House. When Senator Barbara A. Mikulski, D-Md., fought to create this benefit in the ACA, we proudly fought alongside her, and we are going to fight even harder to make sure it’s not taken away.
As we approach March 25, when the Supreme Court will hear oral arguments in two cases challenging the birth control benefit, Planned Parenthood Federation of America is pressing the pedal to the metal to make sure every American knows that this benefit is basic health care for women.
When insurance coverage does not include or cover the full cost of birth control (as was common before the Affordable Care Act), women of childbearing age must either pay up or go without it. The cost of reliable, long-acting birth control, such as the intrauterine device, can climb to several hundred dollars, making it financially out of reach for many women.
With one-third of all American women living at “the brink of poverty,” according to the Shriver Report released in January, access to birth control is not just a health issue; it’s also an economic issue. When a woman can’t afford birth control, she may use it inconsistently or not at all. Washington University’s Contraceptive CHOICE Study demonstrated that when women get access to the birth control method of their choice with no financial barrier, there is a significant drop in unintended pregnancy and abortion rates. In addition, nearly 60 percent of women who use the birth control pill use it for medical reasons, such as management of endometriosis and painful menstrual periods. From every angle, then, no-copay birth control is basic health care.
Women have this benefit because the Affordable Care Act, which was signed into law in 2010, required that critical preventive health services — defined by medical experts, not politicians — should be included as comprehensive benefits for women under the new law. The nonpartisan Institute of Medicine recommended that prescription birth control should be included, and therefore covered, just like other preventive benefits. The IOM knew what we have known all along — that birth control is basic preventive women’s health care.
Despite the inclusion of birth control as preventive health care based on medical science, opponents were on the attack. Planned Parenthood Federation of America — together with NARAL Pro-Choice America, National Women’s Law Center, CREDO and the American Civil Liberties Union — launched a nationwide effort to demonstrate widespread support for birth control and the need for access without cost barriers. We collected nearly 350,000 comments in support of the birth control benefit written by women from all 50 states.
Typical was this comment from 29-year-old Elaine of Knoxville, Tenn.
“I’ve been on birth control pills since I was 17, when I started developing ovarian cysts. I now have endometriosis. I wish people understood that for some people, these pills are vital whether they are sexually active or not. Birth control pills may be preventing me from having surgery. Even with insurance I was paying about $400 a year. I also have other health problems and doctors to deal with. When I was surprised by my pharmacist and told I was suddenly paying $0, I was thrilled! It’s nice to get a break.”
Already, 27 million women nationally are able to get the same break, and millions more will join them as they sign on to new health care policies.
Those who want to deny women this basic health care want to turn back the clock on women’s ability to manage their personal and professional lives. In a brief filed in support of the corporations asking the Supreme Court to be able to refuse to provide insurance coverage for birth control, the Beverly LaHaye Institute asserted that women with access to birth control may become unable to “enter into and maintain desired marital relationships.” These views of birth control are un-tethered to medical science and demeaning to women.
These opponents hide behind a smokescreen of religious liberty. Don’t be fooled. Churches and other houses of worship were always exempt from having to provide this coverage.
As for the two for-profit corporations challenging the birth control benefit before the Supreme Court, they are not religious institutions. They are for-profit companies. And there is no threat to the owners’ personal religious beliefs such that they have the right to block health care access for their employees.
Every woman should be able to make her own decision about what birth control method is right for her in consultation with her doctor — not her congressman or her boss. That this obvious point is even up for debate is appalling, and we will never back down in our fight to ensure women’s access to basic health care.
Dana E. Singiser is vice president of public policy and government affairs for the Planned Parenthood Federation of America.