The reality is much less straightforward. When the Institute of Medicine looked at this issue while deciding whether to recommend that birth control be included among preventive services to be provided at no cost, it noted that while contraceptive coverage has expanded for many with private or federal coverage, many women still do not have insurance coverage or, if they do, their copays for prescriptions may have increased in recent years.
The Institute also cited evidence that even small increases like cost-sharing (requiring patients to pay more) create a barrier to preventive services like birth control. When out-of-pocket costs are reduced or eliminated, however, women are more likely to choose more effective methods of contraception. Testimony from the Guttmacher Institute (pdf) supported the preventive benefits of contraception and described the financial barriers to use.
While women with insurance may have coverage for birth control on paper, the actual costs may still pose a barrier to actually getting it — and probably contributes to half of pregnancies in the United States being unintended.
Jessica Arons of the Center for American Progress has a great piece at RH Reality Check, “The High Costs of Birth Control: A Major Barrier to Access.” Arons presents a number of facts and resources on contraceptive costs and use, explaining that “High costs have forced many women to stop or delay using their preferred method, while others have chosen to depend on less effective methods that are the most affordable.”
And Michelle Andrews at Kaiser Health News writes: “With prices ranging from about $1 for a condom to more than $800 for an intrauterine device (IUD), some of these women, maybe a lot of them, might switch methods if they could afford to.” She continues:
That’s exactly what many women’s health advocates hope. Long-acting methods such as the IUD and the hormonal implant are nearly 100 percent effective, require no effort after insertion and protect against pregnancy for up to 10 years. (In contrast, birth control pills are about 92 percent effective, and many other common methods are even less reliable in everyday use.)
For an estimate of how much a woman could expect to spend on birth control depending on her age, method, and insurance coverage, check out this calculator at Mother Jones.
Plus: Sandra Fluke, the law student at Georgetown University who was blocked from testifying at last week’s hearing on insurance coverage for contraception while five clergymen weighed in, testified today at a hearing the Democrats put together on women’s health. Yet in another move to silence debate, Republicans prevented C-SPAN from televising the hearing.