Birth Control Essential Health Benefit

Vox leaked a draft regulation on May 31 revealing the Trump administration’s plans to “gut the Obamacare contraception mandate,” according to The Rolling Stone. The leaked draft, which is currently being reviewed by the Office of Management and Budget, states that it aims to “expand exemptions for religious beliefs and moral convictions for certain entities or individuals whose health plans may otherwise be subject to a mandate of contraceptive coverage.”

This means that, if made official, it will become significantly easier for companies to be exempt from providing health insurance that covers birth control. Trump will abolish the “rule currently ensuring that most women’s insurance covers contraception without a copay,” according to Dylan Scott and Sarah Kliff for Vox.

A friend once told me that without free access to birth control, men and women can never be completely equal. At the time I thought she might be exaggerating a little, but now I realize the truth of that statement. Until access to birth control is widely accepted as a necessary health service, women will never achieve equal opportunity in the workplace or equal respect as independent beings.

The Affordable Care Act, according to a segment by Rebecca Hersher on NPR’s All Things Considered, has increased the number of people using contraception. “One reason more girls and women are using birth control is that the Affordable Care Act requires insurers to fully cover prescribed contraception. That includes the pill, implanted hormonal birth control and intrauterine devices,” Hersher said.

The birth control mandate under Obamacare is “one of eight women’s preventive health benefits that the Affordable Care Act requires health plans to provide without any cost to the patient,” according to Scott and Kliff.

However, if the American Health Care Act becomes law, the Department of Health and Human Services will likely eliminate contraception from its “list of essential preventive services that must be covered by insurance without cost sharing,” wrote Lydia Pace and Eve Rittenburg for The Boston Globe.

Proponents of this plan seem to be largely under the impression that birth control is used only to prevent pregnancy, which is simply inaccurate. It’s used to treat diseases like diabetes, high blood pressure, and heart disease, conditions which also “make pregnancy riskier and have contributed to the rise in maternal deaths in the United States seen in the last two decades,” according to The Boston Globe. 

And even if you’re selfish and only want to pay for things that benefit you, everyone benefits from women being able to control how many kids they have. Overpopulation is an issue that affects everyone, and the world is severely overpopulated right now, due in large part to the lack of knowledge about or access to birth control in less developed or developing countries. The US should not follow suit.

I recently read The Handmaid’s Tale, a novel about a dystopian America in which reproductive-aged women are forced to serve as concubines for their “Commanders” to combat a declining birth rate. They are granted no freedom and valued only for their ability to produce children. The novel is less of an actual prediction for the future and more of an exaggeration of what women currently face: great difficulty in being granted value as independent people and not as mechanisms by which to continue the human race. 

I was driving past the Planned Parenthood in Walnut Creek a few weeks ago and saw a group of protestors standing outside, boasting anti-abortion and anti-birth control signs labeling women associates of the devil for using either of these services. Sadder to me than the fact that those people actually thought they were doing something good for society is the fact that any woman going into the building with intent to take control of her own life or prepare for her future would be confronted with signs calling her evil simply for not wanting to have kids. 

People can have whatever moral beliefs they want, although I might disagree, but they should not be legally allowed to use those beliefs to harm other people. And people are actually harmed when their access to contraceptives is limited, either by lack of physical access or an impossibly high price. A study published in Health Affairs by Nora Becker revealed that women spent $248 more on average for an IUD and $255 more annually for oral contraceptive pills before the Affordable Care Act went into effect, and that’s the reality we’re soon to return to. Not everyone can afford that.

With the legalization of the birth control pill in 1960, Becker wrote that women who had access compared to those who didn’t “had better financial outcomes, better educational outcomes, and that their children actually had better educational and financial outcomes.” There’s really no one who doesn’t benefit from women having access to affordable birth control, unless you’re counting potential future children who haven’t actually come into existence yet as people.

Those who support Trump’s plan fail to understand, or maybe just don’t care, how much this actually matters for women. It’s not just making birth control a little bit more expensive, it’s allowing other people to limit your reproductive options and potentially cause serious harm to your wellbeing for their moral beliefs. Beliefs founded on the idea that women should not have control over their own selves. Dr. Anne Davis, an OB/GYN and consulting medical director for Physicians for Reproductive Health, told Jacqueline Howard for CNN that following Trump’s inauguration, many women were “shaken with worry” and “had tears in their eyes this week as they waited in her office.”

I feel like it’s easy for some people to see birth control as some small medical concern or unnecessary luxury good rather than what it is: something that plays a vital role in most women’s lives and a vital role in allowing women to pursue careers and fulfilling lives outside of parenthood. My mom is a lawyer, and I remember her telling me when I was much younger, maybe 10 years ago, that women in her law firm were given far fewer promotions and far less respect than men, because they were assumed to be less committed to the job and more committed to raising families. It was assumed that all of them would inevitably have kids and leave the law firm behind.

Hopefully the increase in use of birth control since then has changed that perception, but the truth, as evidenced by this leaked document, is that many people still do not respect the use of birth control as a necessary health service. Making it possible for companies to exempt themselves from covering contraceptives in their health care plans is a huge step backward for women’s rights and a sign that the lives of unborn or not-yet-conceived children are still valued more by legislators than the lives of living women.