Birth Control: Will It Become the Ultimate Luxury?

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When I was 16, I decided to get on birth control. My high school boyfriend and I were chomping at the bit to do the deed, and I wanted to act responsibly (high-five to my teenage self!). Back then, for me, that meant taking the Pill. And since I had less-than-zero intention of sharing my desire to become sexually active with my busy single mom, I hightailed it to a Planned Parenthood in a neighboring New Jersey town. There, a doctor discussed my options with me, conducted a pelvic exam—my first—and dispensed a prescription. It was a seamless, formative experience.

Fast-forward to today. While a slew of women (some of them peers I know and admire) have bravely, publicly acknowledged that they’ve had abortions, I have a different confession: I’ve never been pregnant. A big ­reason is that I’ve had easy access to affordable birth control.

Why am I revealing this non-news? Because while much of the reproductive-rights conversation is centered on abortion, the Trump administration is also waging war on your birth control—the very thing that prevents the need for an abortion.

Like me, 99 percent of women who have had sex have used birth control at some point. And currently, more than 62 million are getting it for free. (That’s largely thanks to the 2010 Affordable Care Act, or ACA—which requires health insurers to fully cover all FDA-approved forms of contraception—and to clinics such as Planned Parenthood that receive government funding for “family planning services.”) This has helped the teen and unintended pregnancy rates drop to historic lows.

But that could all change…and it has already begun. “We are seeing a deeply concerning attack on access to affordable, high-quality contraceptive care,” says Kinsey Hasstedt, senior policy manager at the Guttmacher Institute, a research and policy organization committed to advancing sexual and reproductive health and rights. Since last year, the government has made moves to:

Kill the ACA and gut Title Xa federal program that funds free or cheap contraception for some 4 million low-income women (a majority are under 30 years old and more than 60 percent are women of color). Title X helps prevent more than 800,000 unintended pregnancies a year, which would otherwise result in close to 300,000 abortions.

Eliminate federal funding for orgs such as Planned Parenthood. This would mean fewer clinics, longer drives, endless wait times, or no access at all for those who can’t get birth control through insurance. (For the record, abortions make up just 3 percent of PP’s ­services, and they are almost never paid for with federal tax dollars.)

Make it easier for employers and schools to refuse to cover birth control for any moral or religious reason,putting hundreds of thousands of people at risk for steep out-of-pocket costs. At the same time, the administration is appointing Supreme Court justices who could ensure these plans become law. If that happens, birth control could cost American women at least $1.4 billion more every year!

Over the past half century, contraception has been ­crucial to women’s advancement, which is why it needs to remain accessible and cost-free rather than a financial burden. (This isn’t even remotely controversial: 96 percent of American voters support contraception access.) Yet government ­officials are trying to halt or, worse, eradicate this progress.

“The message from the administration on birth control is, ‘You’re on your own,'” says Susan Inman, a chief counsel at the Center for Reproductive Rights. Adds Rachel Fey, director of public policy at Power to Decide, a campaign to prevent unplanned pregnancy: “This is real. Alarm bells need to ring. I’ve been doing this for 18 years, and this is the greatest number of threats I’ve seen in my career.”

If this is all sounding a ­little too Handmaid’s Tale, keep reading. Cosmodebriefed top experts for advice on how to stop the erosion of your birth-control access. I hope you’ll join me in letting politicians know that we see what’s happening and we’re not forfeiting our ­reproductive rights.

birth-control-pills-pink-background

STEP 1: Assess Your Risk

Consider which statements apply to you. The more you identify with, the higher your chances of ­losing access to affordable birth ­control. None seem relevant? Great, you can still help others.

◻️ I don’t have health insurance.

◻️ I don’t qualify for Medicaid (aka the government program for people with low incomes).

◻️ I have health insurance through my religion-affiliated workplace or school (e.g., I work for a Catholic university or a church). Or it seems like my employer opposes birth control for “moral” reasons.

◻️ I get my BC from Planned Parenthood or another publicly funded clinic.

◻️ I live in a rural area or “red” state.

◻️ I don’t own a car or have access to one.

◻️ I pretty much live paycheck to paycheck.

THE UNITED STATES OF BIRTH CONTROL

As the federal government aims to restrict access, some states are rushing to expand it. A guide to bright spots and danger zones.

Great States Doing Good Things for You

Certain states now require all FDA-approved forms of birth control be fully covered by state-regulated insurers. So even if the ACA dies, local women’s free BC may not.

  • California
  • District of Columbia
  • Deleware
  • Illinois
  • Massachusetts
  • Maryland
  • Maine
  • Nevada
  • New York
  • Oregon
  • Vermont
  • Washington

Meanwhile, other states have passed laws allowing patients to get 12 months of birth-control pills at once, sparing them frequent pickups (and reducing unintended pregnancy rates by up to 30 percent).

  • California
  • Colorado
  • Connecticut
  • District of Columbia
  • Deleware
  • Hawaii
  • Illinois
  • Massachusetts
  • Maryland
  • Maine
  • New Hampshire
  • Nevada
  • New York
  • Oregon
  • Rhode Island
  • Virginia
  • Vermont
  • Washington

Where Pharmacists Can Reject You

On the rise: reports of pharmacists declining to dispense birth control because of personal beliefs. In 13 states, they can flat out refuse to honor your prescription.

  • Alabama
  • Arkansas
  • Arizona
  • Deleware
  • Georgia
  • Idaho
  • Mississippi
  • North Carolina
  • New York
  • Oregon
  • Pennsylvania
  • South Dakota
  • Texas

In six, they can even hold on to or return an Rx instead of referring it to someone else, potentially forcing a woman to go back to her doctor for a new one.

  • Arkansas
  • Arizona
  • Georgia
  • Idaho
  • Mississippi
  • South Dakota

And Where Pharmacists Can Be Heroes

As of January, 10 states and Washington, D.C., allow pharmacists to prescribe birth control, bypassing the need for an MD visit. Many facilities are still in the process of rolling out their programs. Visit BirthControlPharmacies.com to see what’s available near you.

  • California
  • Colorado
  • District of Columbia
  • Hawaii
  • Maryland
  • New Hampshire
  • New Mexico
  • Oregon
  • Tennessee
  • Utah
  • Washington

Places At-Risk Women Remain Stranded

Only a handful of states still haven’t expanded Medicaid coverage or used a family-planning program to at least offer free contraception to cash-strapped citizens who don’t qualify for Medicaid.

  • Idaho
  • Kansas
  • Nebraska
  • South Dakota
  • Tennessee

Really, Nebraska?

Planned Parenthood is being targeted by a new law denying Title X cash (used for free or low-cost birth control) to clinics that refer for or perform abortions. The PP in Lincoln, the capital, serves about 4,000 women who may now face higher costs (or longer wait times at the only other Title X clinic in town, which serves around 1,400).

Similar Laws Targeting Abortion Providers Have Gone into Effect in 12 Other States:

  • Arkansas
  • Arizona
  • Colorado
  • Iowa
  • Indiana
  • Michigan
  • Missouri
  • Mississippi
  • North Carolina
  • Ohio
  • Texas
  • Wisconsin

Step 2: Beware the True Costs

What you could end up paying for birth control if the Affordable Care Act is decimated and clinics such as Planned Parenthood are defunded:

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