The results are in: Birth control is more financial accessible than ever before, and the Affordable Care Act is behind it.
According to a recent study published in Health Affairs, contraceptive spending has gone down by 20 percent since the Obamacare mandate took effect. Under the ACA, private insurers are required to provide full and comprehensive contraceptive coverage — including intrauterine devices, oral contraceptives, under-skin implants, and other forms of FDA-approved birth control options — without charging an additional co-pay.
Before the mandate, contraceptive spending accounted for roughly 44 percent of the average woman’s annual health expenditures, but this number has dropped to 22 percent since the ACA provision was widely adopted in 2013.
“It’s great news that as a result of progress made in the Affordable Care Act, women across the country have more affordable access to critical health care like birth control,” said Sen. Patty Murray (D-WA), who has been a strong advocate for women’s reproductive rights, most recently championing the fight for over-the-counter birth control availability. “This is good for women, it’s good for our country, and it’s progress we need to continue to build on going forward.”
Since the mandate has gone into effect, the average oral birth control user has saved $255 annually, while IUD users have saved $248. Spending on implant devices has also seen a significant drop to $91, a 72 percent decrease. But the most dramatic drop has been in the cost of emergency contraceptives — which have decreased by over 90 percent, to just $1.75 per prescription.
These significant across-the-board drops are promising news for family planning, as longer-term, highly affect contraceptives including IUDs and implants become dramatically more accessible. According to a 2014 Guttmacher Institute analysis, the use of these long-term options are on a steady trajectory, and are poised to aid in a much-needed nationwide drop in unplanned pregnancies.
The U.S. Department of Health and Human Services has made unplanned pregnancies an agenda topic for their Healthy People 2020 campaign, which is working to decrease the rate of unintended pregnancies by 10 percent over the next 10 years. The rate of unplanned pregnancy currently hovers around 51 percent.
Contraceptive spending has dropped significantly, but continues to stand above full coverage for multiple reasons. First, some health plans did not make the shift to co-pay-free coverage when the law first went into effect, causing a more gradual decrease in spending. About one-third of all plans were grandfathered into the law, meaning that they avoided adapting to the majority of shifts created under the ACA and have therefore been exempt from the contraceptive coverage provision. Employers are also not required to cover every brand of contraceptives, so some users choose to pay out-of-pocket for preferred products including certain patches and rings.
Some employers are exempt from certain parts of the contraceptive mandate for religious reasons — most notably the Hobby Lobby craft chain, whose owners were the plaintiffs in a Supreme Court challenge against this Obamacare provision last year.
While women’s spending on birth control has dramatically decreased, it is important to note that their contraceptive coverage under the ACA is by no means a handout. This coverage is earned through achieving benefits from a private health insurer — typically, through employment and the payment of a monthly premium. Likewise, this contraceptive coverage requirement is not available to women who lack employer-sponsored insurance, meaning that those in lower economic classes continue to struggle to access comprehensive family planning services.