No Copay for Birth Control? A Great First Step Towards Truly Universal Access

by Kelly Blanchard, Ibis Reproductive Health

Contraception is a critical preventive health care tool for women and families. Contraception allows women (and their partners) to plan their pregnancies and avoid pregnancy when they don’t want to have a baby, and planned pregnancies are healthier for women and children. Women with planned pregnancies are more likely to get prenatal care and have healthy babies.

Contraception is also a great deal—data shows that every dollar spent on contraception saves $4 or more in costs to the health system.

So, making sure women can access contraception is good health care policy and good fiscal policy. It also ensures that women can decide how to live their lives and shape their families—critical for our human rights.

The Affordable Care Act provides a huge opportunity to make sure women in the United States have access to contraception. Contraception should be on the list of preventive medicines and services that don’t require a co-pay—that makes health and fiscal sense. We are thrilled that contraception is included as preventive health care in the IOM report and hope that Secretary Sebelius will make sure contraception is covered without a co-pay based on the huge body of evidence showing contraception is critical preventive health care.

We also hope that this will only be the start of a discussion about ways to improve access to contraception.

To improve access, we should also change Medicaid policy so that over-the-counter (OTC) methods (like condoms, spermicides, and sponges) are covered for low-income people so that women and men who prefer those methods have easy access to them.

The data also show that oral contraceptives, “the pill”, are safe and effective and meet all the FDA criteria to be available OTC. We look forward to the day that we have a pill directly available in the pharmacy or the supermarket. Given the popularity of the pill (it is the most popular method among women in the US under 44), easier access to this safe and highly effective contraceptive, covered by Medicaid and other insurance plans, could make access to and use of contraception easier. Studies show women can accurately determine whether they are a good candidate for the pill, and that women who access the pill over-the-counter in a pharmacy are more likely to keep using it. An OTC pill would also improve contraception access for women who won’t benefit from health care reform—like undocumented women—as well as for young women on a parent’s plan who need confidential access to a method or don’t have a provider they feel comfortable asking for a prescription.

We celebrate the evidence-based IOM recommendation to include contraception as key preventive health care for women in the US and look forward to a DHHS decision to cover contraception without a co-pay in the new exchanges. We are also thrilled that the recommendation includes the full range of FDA-approved methods, indicating that prescription and non-prescription contraceptives should be covered.  But we also hope this is only the beginning—we look forward to the pill being available without prescription in your local pharmacy and supermarket in the not too distant future.  In the meantime, we urge Secretary Sebelius to implement the IOM recommendations and ensure that prescription and OTC methods are covered at no additional cost through Medicaid and other subsidized plans.

Cross posted from Ibis Reproductive.

This blog is part of the #HERvotes blog carnival.

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