Birth control laws 2017

Contents

WHO NEEDS CONTRACEPTIVES?

  • There are 61 million U.S. women of reproductive age (15–44).1 About 43 million of them (70%) are at risk of unintended pregnancy—that is, they are sexually active and do not want to become pregnant, but could become pregnant if they and their partners fail to use a contraceptive method correctly and consistently.2
  • Couples who do not use any method of contraception have approximately an 85% chance of experiencing a pregnancy over the course of a year.3
  • In the United States, the average desired family size is two children. To achieve this family size, a woman must use contraceptives for roughly three decades.4

WHO USES CONTRACEPTIVES?

  • More than 99% of women aged 15–44 who have ever had sexual intercourse have used at least one contraceptive method.5
  • Some 60% of all women of reproductive age are currently using a contraceptive method.6
  • Ten percent of women at risk of unintended pregnancy are not currently using any contraceptive method.6
  • The proportion of women at risk of unintended pregnancy who are not using a method is highest among those aged 15–19 (18%) and lowest among those aged 40–44 (9%).2
  • Eighty-three percent of black women at risk of unintended pregnancy are currently using a contraceptive method, compared with 91% of their Hispanic and white peers, and 90% of their Asian peers.2
  • Among women at risk of unintended pregnancy, 92% of those with an income of at least 300% of the federal poverty level and 89% of those living at 0–149% of poverty are currently using a contraceptive method.2
  • A much higher proportion of married women than of never-married women use a contraceptive method (77% vs. 42%), largely because married women are more likely to be sexually active. But even among those at risk of unintended pregnancy, contraceptive use is higher among currently married women than among never-married women (93% vs. 83%).2
  • Unmarried women who are cohabiting fall between married women and unmarried women who are not cohabiting: Some 90% of at-risk women living with a partner use a method.2
  • Contraceptive use is common among women of all religious denominations. For example, eighty-nine percent of at-risk Catholics and 90% of at-risk Protestants currently use a method. Among sexually experienced religious women, 99% of Catholics and Protestants have ever used some form of contraception.7

WHICH METHODS DO WOMEN USE?

  • Seventy-two percent of women who practice contraception currently use nonpermanent methods—primarily hormonal methods (i.e., the pill, patch, implant, injectable and vaginal ring), IUDs and condoms. The rest rely on female (22%) or male (7%) sterilization.6
  • The pill and female sterilization have been the two most commonly used methods since 1982.6,8,9

  • Four out of five sexually experienced women have used the pill.5
  • The pill is the method most widely used by white women, women in their teens and 20s, never-married and cohabiting women, childless women and college graduates.2
  • The use of hormonal methods other than the pill has increased with the advent of new options. The proportion of women who have ever used the injectable increased from 5% in 1995 to 23% in 2006–2010. Ever-use of the contraceptive patch increased from less than 1% in 2002 to 10% in 2006–2010. Six percent of women had used the contraceptive ring in 2006–2010, the first time this method was included in surveys.5
  • Reliance on female sterilization varies among subgroups of women. It is most common among blacks and Hispanics, women aged 35 or older, ever-married women, women with two or more children, women living below 150% of the federal poverty level, women with less than a college education, women living outside of a metropolitan area, and those with public or no health insurance.2
  • Some 68% of Catholics, 73% of Mainline Protestants and 74% of Evangelicals who are at risk of unintended pregnancy use a highly effective method (i.e., sterilization, the pill or another hormonal method, or the IUD).7
  • Only 2% of at-risk Catholic women rely on natural family planning; the proportion is the same even among those who attend church at least once a month.7
  • In 2014, about 14% of women using a contraceptive relied on a long-acting reversible contraceptive method, or LARC (12% used the IUD and 3% used the implant).6 This follows a trend in increasing proportions of women using LARCs, from 2% in 2002 to 6% in 2007 and 9% in 2009.10,11
  • Among contraceptive users, the groups of women who most commonly use an IUD or implant are 25–34-year-olds, those born outside of the United States, those living in a Western state, those who report their religious affiliation as “other” and those who have ever stopped using a non-LARC hormonal method. At least 16% of women in these groups use a LARC method.10
  • Among female contraceptive users in the United States, those most likely to use a LARC method are women who have had a child and those who have ever stopped using a non-LARC hormonal method.10
  • Some 5.5 million women rely on the male condom. Condom use is most common (i.e., at least 25% greater than the national average of 15%) among 15–19-year-olds, those who report their religious affiliation as “other,” those born outside of the United States, college graduates, those who are uninsured and those who are nulliparous or are expecting at least one (more) child.6
  • Ever-use of the male condom increased from 52% in 1982 to 93% in 2006–2010.5
  • Dual method use offers protection against both pregnancy and STIs. Some 8% of women of reproductive age simultaneously use multiple contraceptive methods (most often the condom combined with another method).12
  • The proportion of all sexually experienced women who have ever used withdrawal increased from 25% in 1982 to 60% in 2006–2010.5
  • Seven percent of men aged 15–44 have had a vasectomy; this proportion increases with age, reaching 16% among men aged 36–45.13

Adolescent CONTRACEPTIVE USE

  • Among women aged 15–19 who were at risk of unintended pregnancy in 2006–2010, 82% were using a contraceptive method, and 59% were using a highly effective method.14
  • Among sexually experienced 15–19-year-olds during that period, 78% of women and 85% of men reported having used a contraceptive the first time they had sex; 86% and 93%, respectively, said they did so the last time they had sex.14
  • In 2006–2010, the odds of giving birth before age 20 were twice as high for adolescent women who had not used a contraceptive method at first sex as for those who had.14
  • The male condom was the most commonly used method at first sex and at most recent sex among both adolescent men and women in 2006–2010.14
  • Among the 2.5 million sexually active women aged 15–19 who reported current (i.e., within the last three months) use of contraceptives in 2011–2013, 55% relied on the condom; 35% on the pill; 20% on withdrawal; 8% on the injectable, patch or ring; and 3% on the IUD.15,16
  • In 2006–2010, 20% of sexually active females aged 15–19 and 34% of sexually active males the same age reported having used both the condom and a hormonal method the last time they had sex.14

CONTRACEPTIVE EFFECTIVENESS

  • When used correctly, modern contraceptives are very effective at preventing pregnancy. Among U.S. women at risk of unintended pregnancy, the 68% who use contraceptives consistently and correctly throughout the course of any given year account for only 5% of all unintended pregnancies; in contrast, the 18% who use contraceptives inconsistently account for 41% of unintended pregnancies, and the 14% who do not use contraceptives at all or have a gap in use of at least one month account for 54% of unintended pregnancies.4

  • Contraceptive failure rates are defined as the percentage of users who will become pregnant within the first 12 months of initiating use. Perfect-use failure rates apply to those who use a method consistently and correctly. Typical-use failure rates take into account inconsistent and incorrect use by some users.
  • The contraceptive implant and the IUD are the most effective reversible contraceptive methods available, with failure rates of around 1% for both perfect and typical use. These methods have low typical-use failure rates because they do not require user intervention.3,17
  • The pill and the injectable have typical use failure rates of 7% and 4%, respectively;17 both methods have a perfect-use failure rate of less than 1%.3 The male condom is 98% effective with perfect use;3 however, the method’s failure rate increases to 13% with typical use.17 Male and female condoms are the only contraceptive methods available that prevent pregnancy and protect against STIs, including HIV.17

THE BROAD BENEFITS OF CONTRACEPTIVE USE

  • Women and couples use contraceptives to have healthier pregnancies, to help time and space births, and to achieve their desired family size.18
  • Family planning has well-documented health benefits for mothers, newborns, families and communities. Pregnancies that occur too early or too late in a woman’s life and those that are spaced too closely negatively affect maternal health and increase the risk of low birth weight.19
  • The ability to delay and space childbearing is crucial to women’s social and economic advancement. Women’s ability to obtain and effectively use contraceptives has a positive impact on their education and workforce participation, as well as on subsequent outcomes related to income, family stability, mental health and happiness, and children’s well-being. However, the evidence suggests that the most disadvantaged U.S. women do not fully share in these benefits, which is why unintended pregnancy prevention efforts need to be grounded in broader antipoverty and social justice efforts.20
  • Many hormonal methods—the pill, vaginal ring, patch, implant and IUD—offer a number of health benefits in addition to contraceptive effectiveness, such as treatment for excessive menstrual bleeding, menstrual pain and acne.21
  • In 2015, the most common reason women aged 18–24 gave for using the pill was to prevent pregnancy (93%); however, 70% of pill users also cited noncontraceptive health benefits as reasons for use.21 Some 7% of pill users aged 18–24 relied on the method for exclusively noncontraceptive purposes.21

EMERGENCY CONTRACEPTION

  • Emergency contraception is a way to prevent pregnancy after unprotected sex or contraceptive failure; it has no effect on an established pregnancy.22
  • The majority of dedicated emergency contraceptive products currently on the market are effective when taken within 72 hours of unprotected sex (although they are decreasingly effective for up to five days after unprotected sex). These pills consist of a concentrated dosage of one of the same hormones found in birth control pills. Another product, containing ulipristal acetate, is also effective for up to five days.22
  • Nonhormonal copper IUDs inserted up to five days after unprotected intercourse can also act as emergency contraception.22
  • One in nine sexually experienced women of reproductive age have used emergency contraception, as of 2010. The majority of these women used emergency contraception only once (59%).23
  • Use is highest among 20–24-year-olds and never-married women, of whom 23% and 19%, respectively, report having ever used emergency contraception.23
  • Women report two main reasons for using emergency contraception: Forty-five percent fear that their regular method will fail, and 49% report having had unprotected sex.23

WHO PAYS FOR CONTRACEPTION?

  • Contraceptive services and supplies can be costly. The most effective, long-acting methods can cost hundreds of dollars up front. Even methods that are relatively inexpensive on a per-unit basis (such as condoms) can cost substantial amounts over a year, not to mention over the 30 years that a woman typically spends trying to avoid pregnancy.18
  • In 2014, an estimated 20 million women were in need of publicly funded contraceptive services and supplies because they either had an income below 250% of the federal poverty level or were younger than 20 (and thus were likely to have had a heightened need—for reasons of confidentiality—to obtain care without depending on their family’s resources or private insurance). The federal and state governments provide funding for family planning services and supplies to help women meet these challenges.24
  • Publicly funded family planning services help women to avoid pregnancies they do not want and to plan pregnancies they do. In 2014, these services helped women avoid nearly two million unintended pregnancies, which would likely have resulted in 900,000 unplanned births and nearly 700,000 abortions.24
  • In 2010, every $1.00 invested in helping women avoid pregnancies they did not want to have saved $7.09 in Medicaid expenditures that would otherwise have been needed to pay the medical costs of pregnancy, delivery and early childhood care.25
  • Millions of U.S. women rely on private insurance coverage to help them afford contraceptive services and supplies. The Affordable Care Act requires most private health plans to cover a designated list of preventive services without out-of-pocket costs to the consumer, including all FDA-approved contraceptive methods and contraceptive counseling for women.26
  • As of July 2018, some 29 states also have laws in place requiring insurers that cover prescription drugs in general to cover the full range of FDA-approved contraceptive drugs and devices.27

Access to Birth Control, Sex Ed, and Women’s Health Services Is at Risk: The Politics of Contraception in Modern America

Sex ed, or learning about the birds and bees in public school, isn’t a given anymore.

July 25, 2018

Political protesters may shout and hold signs telling the U.S. government to “get your laws off my body,” but the current presidential administration is trying to do just the opposite.

While women’s contraception has until recently been readily accessible and free of cost under most healthcare plans through the Affordable Care Act, implemented when Democrat Barack Obama was president, politics can play a significant role in how that can change. Under Republican President Donald Trump, birth control accessibility and affordability has been threatened.

Related: Birth Control in America: A Brief History of Contraception

“The Trump administration takes a very different approach than the Obama administration did,” said Adam Block, PhD, an assistant professor of public health at New York Medical College in Valhalla, New York. The Obama administration wanted to make birth control available more broadly. The Trump administration is shifting the decision about back into the hands of employers.”

Related: What Is Emergency Contraception?

As a result, how people obtain and what they pay for birth control depends on their insurance coverage (or lack thereof), their finances, and what they learn about their options either from a healthcare provider or another source.

How the Affordable Care Act Works for Contraception

While Obama was president, the Affordable Care Act (ACA) became law in 2010 (1). It provided comprehensive health coverage for everyone in the United States to pay for and get health insurance. The ACA allowed for women to pay nothing for their contraception (2), including birth control pills, IUDs, sterilization, and emergency contraception, among other choices.

When the ACA initially passed, there were exemptions for religious organizations such as a Catholic Church employing primarily priests and nuns; Catholic hospitals employing thousands of nonreligiously affiliated people were not allowed the exemption. But in 2012, the private arts and crafts retailer Hobby Lobby brought suit against the Obama administration and asked for the same religious exemption. In 2014, the U.S. Supreme Court ruled (3) in Hobby Lobby’s favor.

In October 2017, after Trump became President earlier in the year, he and his administration allowed any employer to apply for a moral or religious exemption if the business wanted to deny contraception coverage through the employer’s health insurance plan based on sincerely held religious beliefs opposed to such coverage.(4)

The issue has been challenged by several states and is now being debated in the courts, said Block.

Related: Shop Now for Affordable Birth Control in Case of a Coverage Change

New Question at Stake: Who Pays for Birth Control?

As the policy works its way through the court system, the question of who pays for birth control is at stake.

As with abortion, birth control availability may differ depending on how conservative a state is, should the policy on contraception and religious/moral exemptions move forward, said Block.

Contraception Options Vary by Cost and Insurance Coverage

Block said that some ACA-based insurance plans, typically the most basic ones, might offer only state minimum requirements— so perhaps just birth control pills and hormone injections but not costlier methods like IUDs. In these cases, Block says people can always buy more coverage to make more options available.

“People know their earnings,” he said. “They should budget to be able to purchase birth control, shop around, and see if there are generic versions available or nonhormonal contraceptives” to see how to lower costs.

Paying Out of Pocket for Birth Control Can Be Prohibitively Expensive

But for lower-income women, such policies have a different impact, said Erica Sackin, the director of political communications for Planned Parenthood Federation of America and Planned Parenthood Action Fund, both based in Washington, DC. “For a number of women, even when they have to pay an insurance copay, let alone out of pocket, contraception can be too expensive. If you have to pay out of pocket, birth control pills can cost up to $600 a year, for example. If you are young, a student, etc., it can be completely unattainable.”

What Could Happen if Contraception Laws Change

If contraception is no longer covered by U.S. health insurance plans, the number of teen pregnancies and unintended pregnancies is sure to rise, Sackin said. Under the ACA, the birth control benefit meant that 62.4 million women had access to no-copay birth control. As a result, teen pregnancy is now at an all-time low and the rate of unintended pregnancy is at a 30-year low, said Sackin. With the current political climate, “the Trump administration is completely walking this back,” she said. As of 2017, the Trump administration made changes that mean birth control is no longer guaranteed, said Sackin.

Limiting Access to Birth Control Education, Options

Another issue tied up in the courts that directly affects women and their contraceptive options is Title X (5), the nation’s grant program for affordable birth control. It ensures that every person has access to preventative care, birth control, and STD treatment and serves 4 million people a year, said Sackin.

What to Know About Possible Changes Such as Defunding Groups Like Planned Parenthood

In February 2018, the Trump administration made a Funding Opportunity Announcement (FOA), (6) saying it was changing the priorities of the Title X program, said Sackin. The FOA stipulates that all future Title X grants will be prioritized for organizations or providers that counsel patients only about fertility awareness, abstinence, and/or marriage counseling, rather than organizations that specialize in the full range of birth control and other options in reproductive healthcare. (Any other organizations currently receiving funding through Title X will see it end this year, even if the grant was scheduled to last longer.) In the past, grants were distributed to those who were covering the greatest patient needs. Planned Parenthood and other organizations have gone to court with the Trump administration over this, and the case is ongoing, Sackin said.

Legal Changes May Penalize Groups That Deliver Reproductive Health Services

The FOA change effectively penalizes organizations that provide reproductive health services along with basic healthcare, as Planned Parenthood does, and prevents them from getting such funding.

Title X: What Is the Gag Rule?

The Trump administration also introduced the gag rule (7) as part of Title X. While it is currently in a 60-day period seeking comments from the public, the gag rule would make it illegal for any healthcare worker at an organization or clinic funded by Title X to be able to tell patients how they can legally and safely access abortion. It would also remove the guarantee that providers aren’t withholding information about pregnancy options, and it would open the door to having more pregnancy crisis centers, which are antiabortion advocate organizations that don’t normally provide healthcare, said Sackin. “If you go to one of those, if you were recently diagnosed with cancer, your doctor could refuse to tell you that an abortion could save your life,” she said. The gag rule also imposes restrictions on the ability of organizations like Planned Parenthood to participate in the Title X program.

Who Opposes Changes to Title X?

As a result of the gag rule, many medical groups (8) also oppose the proposed changes to Title X, including the American Academy of Pediatrics, American College of Obstetricians and Gynecologists (ACOG), and Power to Decide, the campaign to prevent unplanned pregnancy. They say that the changes violate the oath healthcare providers take when they become providers: to do no harm and tell patients about all the healthcare options available to them. “ eliminate the guarantee that a doctor will give you all the healthcare information that is available,” said Sackin.

The Potential Impact of Funding Changes for Women

The FOA fight is an attempt to push women to either not use any form of birth control except abstinence or the rhythm fertility method, and it is dangerous,” said Sackin. “The rhythm method is often less effective than other forms of birth control. If you have an abusive relationship or have less control over the details of your life, this is not a method that will work for you. When we have seen states try to do similar policies that remove women’s access to healthcare, women’s health suffers. The rates of unintended pregnancies go up.”

While the fight surrounding Title X continues, particularly over the gag rule, it isn’t safe to think that it will be overturned by the courts. Historically, the Reagan administration tried to do something similar (9) about 30 years ago. It was challenged in the courts, but it was ruled to be constitutional in 1991. (The Clinton administration rescinded the policy shortly after coming into office.) But the fact that it was deemed constitutional means that the current battle over changes to Title X could ultimately become law.

Healthcare Debates about Women’s Health, Reproductive Rights Spur Political Change

In response to the sweeping changes that the Trump administration has already put into law as well as the pending legislation that may become law, more women have chosen to run for office at the local, state, and national levels to try to promote issues, such as reproductive health, women’s health, and other topics.

“Because there are so many people making consequential decisions about healthcare and so many policies are slipping under the radar, it really threads the needle about what is in place and how it affects your healthcare,” said Sackin. Consequently, “it’s not a coincidence that we are also seeing historic numbers of women (10) fighting for change and, both marching in the street and running for office. One in five people in this country have taken such action since Trump came into office and the top reason they list is for women’s rights,” she said.

Supreme Court Changes May Lead to Weaker Reproductive Rights

In early July, Trump named Brett Kavanaugh, a judge on the U.S. Court of Appeals for the DC Circuit, as his nominee for an opening on the Supreme Court. (11,12) Democrats fear that Kavanaugh, a lifelong Catholic, may help to overturn the rulings on Roe vs. Wade that legalize abortion in the United States. At press time, the Planned Parenthood Action Fund was organizing around the nomination, hoping to convince some Republican senators as well as some Democratic senators who may be undecided to vote against Kavanaugh’s nomination to the nation’s highest court. Kavanaugh needs 50 votes to win; there are currently 49 Democratic senators and 51 Republican senators. (13)

Is birth control covered by your insurance? Are you concerned about the cost of birth control? When it comes to the facts on birth control coverage, here’s what you need to know.

1. You have rights as a patient.

When it comes to accessing birth control, you gotta know your rights! Planned Parenthood is here to help everyone get the birth control they need — no matter where you’re from or what your citizenship status is. The following guidance aims to support patients and their families in being aware of their rights as immigrants.

2. Americans support including birth control under health insurance plans as preventive health care.

  • Birth control use is nearly universal. Ninety-nine percent of all sexually experienced women and 98% of sexually experienced Catholic women have used it at some point in their lives.

  • Since the Affordable Care Act (ACA) was passed in 2010, most health insurance companies have been required to cover birth control at no copay in their plans. The birth control mandate finally made this essential health care service affordable. But the ACA and its birth control coverage mandate have been under attack by anti-birth control politicians.

  • Fifty-six percent of voters support the ACA birth control coverage benefit, including 53% of Catholic voters and 62% of Catholics who identify themselves as independents, according to a Public Policy Polling Poll.
  • Sixty-five percent of Millennials (people born between 1981 and 1996) believe that employer health insurance coverage should include birth control at no cost.

3. Access to birth control improves the health of women and their families.

There’s a reason birth control was included as preventive health care — a panel of doctors recommended it. The nonpartisan Institute of Medicine (IOM) recommended that birth control be covered as women’s preventive care because it is fundamental to improving not only women’s health, but the health of their families as well. Medical research has demonstrated this fact for decades. Improved access to birth control is directly linked to declines in maternal and infant mortality.

4. Birth control has had a profound and positive impact on women’s lives.

According to a Guttmacher study, a majority of women say birth control allowed them to take better care of themselves or their families (63%), support themselves financially (56%), complete their education (51%), or keep or get a job (50%).

5. People struggle with the cost of birth control.

This is not just a health issue, it’s an economic issue. The cost of birth control, with or without insurance, can take a toll on a person’s bank account.

  • More than a third of female voters have struggled to afford prescription birth control at some point in their lives, and as a result, used birth control inconsistently.
  • This isn’t surprising considering co-pays for birth control pills typically range between $15 and $50 per month. That adds up to over $600 per year. Other methods, such as IUDs, can cost several hundred dollars, even with health insurance.

6. Any expansion of refusal policies and restrictive birth control rules could deny millions of people access to birth control.

The Trump administration has tried to enact rules that promote employers’ religious beliefs over workers’ ability to access affordable birth control. The rules would make it easier for employers to opt out of the ACA’s requirement to provide birth control coverage in their employer-sponsored insurance plans.

  • Taking away the benefit of copay-free birth control coverage would affect all people who need birth control — including Catholics and non-Catholics. The people who stand to lose birth control coverage without the ACA’s benefit includes nearly 800,000 people who work for Catholic hospitals and receive these benefits through their employer-sponsored health insurance plans. (The Catholic-affiliated system is so large, one in six Americans gets care there.)
  • Approximately two million students and workers at universities with religious affiliations.
  • Forty three percent of students at Catholic universities and colleges are not Catholic.

What this adds up to: millions of hardworking Americans losing access to this critical benefit.

7. Failing to provide birth control coverage is sex discrimination.

Prescription contraceptives are used exclusively by people with female reproductive systems. Failure to provide coverage for prescription contraceptive drugs and devices in health plans that otherwise cover prescription drugs violates the Civil Rights Act because it singles out women. By treating medication needed for a pregnancy-related condition less favorably, failure to cover birth control constitutes discrimination on the basis of sex.

The pill is easy to get, but you need a prescription. Here’s the scoop on where to get birth control pills, how much they cost, and how you might be able to get them for free or low cost.

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How much do birth control pills cost?

Prices vary depending on whether you have health insurance, or if you qualify for Medicaid or other government programs that cover the cost of birth control pills. For most brands, 1 pill pack lasts for 1 month, and each pack can cost anywhere from $0-$50. But they’re totally free with most health insurance plans, or if you qualify for some government programs.

You may also need to pay for an appointment with a doctor or nurse to get a prescription for the pill. This visit can cost anywhere from $35–$250. But under the Affordable Care Act (aka Obamacare), most insurance plans must cover doctor’s visits that are related to birth control. Learn more about health insurance and birth control.

If you’re worried about cost, check with your local Planned Parenthood health center to find out if they can hook you up with birth control that fits your budget.

How can I get birth control pills for free?

There’s a good chance you can get low-cost or free birth control pills if you have health insurance. Because of the Affordable Care Act (aka Obamacare), most insurance plans must cover all methods of birth control at no cost to you, including the pill. However, some plans only cover certain brands of pills or generic versions. Your health insurance provider can tell you which types of birth control they pay for. Your doctor may also be able to help you get the birth control you want covered by health insurance. Learn more about health insurance and affordable birth control.

If you don’t have health insurance, you’ve still got options. Depending on your income and legal status in the U.S., you could qualify for Medicaid or other government programs that can help you pay for birth control and other health care.

Planned Parenthood works to provide services you need, whether or not you have insurance. Most Planned Parenthood health centers accept Medicaid and other health insurance. And many charge less depending on your income. Contact your local Planned Parenthood health center for more information.

Where can I get birth control pills?

You need a prescription for birth control pills. You can get a prescription from a doctor or nurse at a doctor’s office, health clinic, or your local Planned Parenthood health center. In a few states, you can even get a prescription online or directly from a pharmacist.

During your visit, a nurse or doctor will talk with you about your medical history, check your blood pressure, and give you whatever exams you may need. Most people don’t need pelvic exams in order to get birth control pills. Your nurse or doctor will help you decide what’s right for you based on your medical history.

You may be able to get your birth control pills right away during your appointment. Or you’ll get a prescription from the nurse or doctor, and you’ll go pick up your pills at a drugstore or pharmacy.

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The Obama administration generally required employers to cover all forms of birth control approved by the Food and Drug Administration, including pills that critics say may cause fertilized eggs to be aborted.

“No American should be forced to violate his or her own conscience in order to abide by the laws and regulations governing our health care system,” said Caitlin Oakley, a spokeswoman for the Department of Health and Human Services.

But Richard B. Katskee, the legal director of Americans United for Separation of Church and State, an advocacy group that plans to challenge the rules in court, said they imposed an impermissible burden on female employees who want cost-free contraceptive coverage and may be unable to get it.

“Religious freedom is the right to believe and worship as you see fit,” Mr. Katskee said. “It’s never the right to use government to impose costs, burdens or harms on other people. You can’t use the government to make other people pay the price for your religious beliefs or practices.”

The Trump administration on Friday also notified health insurance companies that it would vigorously enforce provisions of the Affordable Care Act regulating coverage of abortion services. The health department reminded insurers that if they cover abortion, they generally cannot use federal funds for that purpose, but must collect separate payments from consumers and must deposit the money in special accounts used exclusively for coverage of abortion services.

Under the new rules, exemptions to the contraceptive coverage mandate would be available to many kinds of employers, including publicly traded companies that said they had religious objections to covering some or all types of contraception.

The Trump administration said that some people would, as a result of the new rules, not receive “coverage or payments for contraceptive services.”

“The government’s legitimate interests in providing for contraceptive coverage do not require us to violate sincerely held religious beliefs” or moral convictions, the administration said. But, it said, officials “do not have sufficient data to determine the actual effect of these rules,” the extra costs that women might incur for contraceptives or the number of unintended pregnancies that might occur.

Birth control benefits

Plans in the Health Insurance Marketplace must cover contraceptive methods and counseling for all women, as prescribed by a health care provider.

Plans must cover these services without charging a copayment or coinsurance when provided by an in-network provider — even if you haven’t met your deductible.

Covered contraceptive methods

FDA-approved contraceptive methods prescribed by a woman’s doctor are covered, including:

  • Barrier methods, like diaphragms and sponges
  • Hormonal methods, like birth control pills and vaginal rings
  • Implanted devices, like intrauterine devices (IUDs)
  • Emergency contraception, like Plan B® and ella®
  • Sterilization procedures
  • Patient education and counseling

Plans aren’t required to cover drugs to induce abortions and services for male reproductive capacity, like vasectomies.

TIP To be sure if a specific method is covered by your plan, check your plan’s materials or ask your employer or benefits administrator.

Birth control benefits rules for employer-provided coverage

If you work for a religious employer

Health plans sponsored by certain exempt religious employers, like churches and other houses of worship, don’t have to cover contraceptive methods and counseling.

If you work for an exempt religious employer and use contraceptive services, you may have to pay for them out-of-pocket. Contact your employer or benefits administrator for more information.

If you work for a non-profit religious organization

Some non-profit religious organizations — like non-profit religious hospitals and institutions of higher education that certify they have religious objections to contraceptive coverage — don’t have to contract, arrange, pay, or refer for contraceptive coverage.

  • If your health plan is sponsored or arranged by this type of organization, an insurer or third party administrator will make separate payments for contraceptive services that you use.
  • You’ll have access to contraceptive services without a copayment, coinsurance, or deductible when they are provided by an in-network provider.

Contact your employer or health plan to learn more.

For women, having access to contraception at a young age may affect how much money they earn in their 30s and 40s, according to a new report from the Institute for Women’s Policy Research released Wednesday.

The report examined the relationship between contraceptive access in the U.S. and a number of outcomes, including educational attainment, labor force participation, career outcomes and earnings. The findings come from decades of research on the economic impact of contraceptive access.

Women who have access to legal contraception beginning at ages 18 to 21 make 5% more per hour and 11% more per year by the time they’re 40, compared to those who don’t, according to the report. That translates to about 63 cents more per hour and $2,200 more per year.

The reason? Having access to birth control measures such as the pill allows women to delay having children, which means they can invest in higher education and choose an occupation, the study’s authors, Anna Bernstein and Kelly M. Jones, noted.

The data came from interviews that were conducted between 1968 and 2003 and published in a 2012 study, but all the numbers have been converted to represent the dollar amount as of the year 2000, Jones tells CNBC Make It. (As a result, the calculation of 63 cents per hour and $2,200 per year is in 2000-era dollars.)

Of course, there are many factors that could impact women’s future earnings that are not directly related to birth control, the researchers said. It is not possible to control a study for all of those factors, including family wealth, personality traits, soft skills, talents and aspirations.

For the study, Bernstein and Jones took a historic look at birth control and found that while access to contraception increased over the decades, so did women’s ability to continue their education, remain in the workforce and earn more.

Their findings gel with other research on the widespread effects of birth control: Contraceptive access has been shown to increase women’s college enrollment by 12% to 20%. The 15% bump in the women’s labor force participation that happened from 1970 to 1990 was largely due to the pill, according to Bernstein and Jones.

On the other hand, an early birth has been shown to disrupt or delay women’s ability to pursue secondary schooling and can have significant effects on their earning potential.

For example, a 2011 study found that women who have their first child fresh out of high school earn 30 fewer college credits than those who waited seven or more years to have kids. Each subsequent birth can further those effects, particularly for low-income households, according to the report.

Also, a study published in 2018 found that having children decreases women’s earnings in Denmark over time, but not men’s. When they had children, men’s incomes still stayed on par with their peers who had no children.

Bernstein and Jones said the study is important because “the knowledge that will have the future ability to control whether and when to have a child can shape a young woman’s aspirations and life plans.”

Contraceptives give women the freedom to invest in their human capital, and develop economic security, they added.

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Birth Control Access

The ACLU seeks government policies that ensure access to affordable contraception; respect voluntariness; protect confidentiality; and prohibit sex discrimination, be it in the form of sanctioning religious refusals or treating contraception differently from other care.

It is imperative that health insurance programs recognize the obvious importance of contraception as a preventive service.

Additional Resources

Challenges to the Federal Contraceptive Coverage Rule (2013 resource)
Nearly 60 lawsuits have been filed across the country challenging the federal rule that employers include contraception in the insurance they provide employees. One of these many cases is likely headed to the U.S. Supreme Court. The cases now being heard pose the fundamental question: Does the right to religious freedom include the right of a business or institution to impose its views on a diverse workforce? We don’t think so.

Promoting Equality: An Analysis of the Federal Contraceptive Coverage Rule (2011 PDF)
This paper explains why the Obama administration’s rule ensuring that insurance plans cover contraception does not conflict with religious freedom protections. It also shows how the theory being pushed by opponents of the rule has far-reaching consequences.

HHS Ensures Affordable Contraception (2011 press release)
In August 2011, the U.S. Department of Health and Human Services announced that all new insurance plans must cover the full range of FDA-approved contraceptive methods, as well as other critical preventive care like screening and counseling for domestic violence, without cost-sharing. This new measure makes effective birth control more affordable for millions of women by eliminating extra out-of-pocket expenses. The policies were recommended by an expert panel of the Institute of Medicine.

Military Lifts Ban on Emergency Contraception (2010 blog piece)
In 2010, the U.S. Department of Defense quietly made public its decision to require that emergency contraception (EC or Plan B) be available at all overseas military facilities.

Ensuring Access to Emergency Contraception After Rape (2007 resource)
Throughout the country, many emergency care facilities fail to offer women who have been raped the treatment they need to prevent pregnancy. Emergency contraceptive (EC) pills, sometimes referred to as the “morning-after pill,” can prevent pregnancy after unprotected intercourse, including rape.

Religious Refusals and Reproductive Rights: Accessing Birth Control at the Pharmacy (2007 PDF)

Your boss would get to decide whether you get access to birth control.

Update, January 14, 2019: A federal court in Pennsylvania entered a nationwide injunction blocking the administration’s latest attack on affordable birth control. This ruling protects the 62 million women who gained access to affordable birth control through the Affordable Care Act.

The fight is far from over. But this is a victory for reproductive health care, and — with your help — we’ll keep pushing. Here’s what you need to know — and how you can help us fight back.

Last month, voters across the country made clear that they care about reproductive health care. Yet just hours after polls closed, the Trump-Pence administration announced final rules to block access to birth control — a form of health care used by nine out of 10 women of reproductive age.

The rules — which roll back birth control access — are set to be effective on January 14, 2019, but ongoing litigation could prevent them from taking effect. We need to do everything we can to raise awareness about the attack.

👏🏾 BIRTH
👏🏼 CONTROL
👏🏻 IS
👏🏿 HEALTH
👏🏽 CARE
The #Fight4BirthControl isn’t over. Add your name to protect our access: https://t.co/j4Bl2Znk6Q

— Planned Parenthood Action (@PPact) November 25, 2018

What do the birth control rules do?

The administration’s rules would gut the part of the Affordable Care Act (ACA) that requires employers to cover birth control in their health insurance plans. Without that requirement, virtually ANY entity that provides health insurance coverage — including businesses, colleges, and universities — could refuse to cover birth control.

Without health insurance, birth control pills typically cost between $15 and $50 per month. That adds up to over $600 per year. An IUD could cost more than $1,100 out-of-pocket.

Sign our message to the administration and your members of Congress:

Tell them: I oppose the latest attempt to let bosses and schools decide who gets birth control coverage.

Sign the petition

What will happen when the birth control rules go into effect, and why are they harmful?

The rules roll back access to birth control for the 62 million women who gained access thanks to the Affordable Care Act. Women of color made up the majority of people who gained coverage for birth control without a copay, including 17 million Latinas and 15 million Black women. Altogether, women saved more than $1.4 billion per year in out-of-pocket costs on birth control pills since the birth control benefit went into effect. That’s a savings of more than $3.8 million EVERY DAY.

Without the ACA’s guarantee of insurance coverage for birth control, many women — especially women of color and young people — won’t be able to afford birth control at all. In fact, before the Affordable Care Act, 57 percent of women ages 18 to 34 said they’d struggled to afford birth control. Forty percent of Black women of reproductive age said they couldn’t afford more than $10 a month for birth control if they had to pay out of pocket.

Taking away access to birth control is a big step backwards for our country.

It risks reversing positive gains for women. According to a study by the Guttmacher Institute, a majority of women said that using birth control allowed them to:

  • take better care of themselves or their families

  • support themselves financially

  • complete their education

  • advance in their careers

Improved access to birth control is also linked to decreases in maternal and infant mortality, as well as historic lows in unintended pregnancy and in pregnancy among teens.

Didn’t the Trump-Pence administration already let bosses refuse to cover birth control?

If these control rules sounds familiar, it’s because we’ve been here before. The administration first tried to make it easier for employers to refuse to cover birth control a little over a year ago. With your help, we fought back. State attorneys general and advocates sued the administration, and two federal courts stopped the rules from taking effect. But the administration made small tweaks to those rules and is continuing to move forward.

What’s different this time around?

Not much. The final version of the birth control rules are basically identical to last year’s rules. They’re likely to continue to be challenged in court. With your help, we’ll do everything we can to make sure they’re struck down.

We need to show the administration and our elected leaders just how MANY of us oppose taking away our access to birth control.

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Federal law, unchanged since 1970, says that Title X funds cannot be used in “programs where abortion is a method of family planning.” The current rules, adopted by the Clinton administration in 2000, say that clinics must give pregnant women an opportunity to receive information and counseling on prenatal care, infant care, adoption and “pregnancy termination.”

The Trump administration has proposed sweeping changes to those rules to “ensure that federal funds are not used to fund the abortion industry in violation of the law.”

Representative Diana DeGette, Democrat of Colorado, has criticized the move, saying “the Trump administration is working furiously to turn back the clock on women’s rights.”

President Trump has also proposed eliminating the requirement for clinics to provide abortion-related information, counseling and referrals on request. As a result, the administration said, Title X funds would be available to “health care providers who refuse to participate in abortion-related activity such as counseling and referrals.”

Under the current rules, clinics that receive Title X funds must provide a broad range of “medically approved family planning methods.” The Trump administration’s proposal would delete the words “medically approved.” The proposal also makes clear that clinics would not have to provide every effective method of contraception.

In contrast, insurers and employer-sponsored health plans are generally required to cover all forms of contraception that have been approved for women by the Food and Drug Administration.

The Trump administration is also proposing stringent rules to require the physical separation of family planning and abortion services at clinics that offer both. Federal health officials estimate that 10 percent to 20 percent of Title X sites do not comply and would have to spend an average of $20,000 each to meet the proposed requirement.

A record number of women — mostly Democrats, many of them galvanized by the threat the Trump administration poses to reproductive freedom — were swept into Congress during in the 2018 midterm elections. The results were still being tabulated on Wednesday when Trump’s Department of Health and Human Services quietly finalized two rules empowering employers, universities and nonprofits to refuse birth control coverage to women.

A third rule, also announced Wednesday, would require insurers on the Affordable Care Act marketplace to charge women a separate monthly bill for abortion coverage — a change that advocates say would be so prohibitively expensive it could force insurers to stop offering the procedure altogether.

Under the Obama administration, only certain churches and religious organizations were exempt from an ACA provision requiring employers to offer insurance plans with coverage for birth control. The new rules, set to take effect in January 2019, would make it much easier for any organization to deny coverage — all they have to do is claim they have “sincerely held religious beliefs” or “non-religious moral convictions” against birth control. The new rules make any coverage, essentially, voluntary: “Entities that object to covering some, but not all, contraceptive items would be exempt with respect to only those methods to which they object.”

There was a certain irony to the timing of HHS’s birth control announcement, just hours after Trump fired Attorney General Jeff Sessions. Sessions’ Department of Justice helped pave the way for these, and other religious refusal rules across the federal government. In October 2017, a few months after Trump issued an executive order broadening the definition of “religious liberty,” Sessions issued guidance to all federal agencies explaining how they could legally apply the new executive order.

As Dena Sher, with Americans United for the Separation of Church and State explained to Rolling Stone a few months ago, the policy ”significantly weakens the principle of church-state separation and serves as a blueprint for using religion to discriminate.”

HHS first debuted the birth control rules at that time, last October, but they fumbled the rollout, trying to rush them through without a federally mandated notice and comment period. Multiple lawsuits followed, and judges in two states issued preliminary injunctions blocking the rules. It’s unclear at this point what bearing those cases, both of which are ongoing, will have on the rules finalized Tuesday.

Advocacy groups were apoplectic about the new rules Tuesday.

“Women resoundingly rejected the Trump-Pence agenda, so Trump and Pence took direct aim at women’s health coverage for birth control and abortion,” Dawn Laguens, Planned Parenthood’s executive vice president, said in a statement. “Women will remember this attack on their basic health care.”

Rachel Laser, president of Americans United for the Separation of Church and State accused the Trump administration of “weaponizing ‘religious freedom’ to justify hurting the millions of women who depend on contraception for their health and equality.”

“The political temper tantrum would almost be laughable if the repercussions on women’s health weren’t so serious,” said Mary Alice Carter, of the HHS watchdog Equity Fwd, in a statement. “Today’s rules are further evidence that Congress must hold HHS accountable for the great harm they are causing the millions of women and men who rely on the agency’s programs.”

The new rules were announced just hours after voters in Alabama overwhelmingly approved a constitutional amendment granting full legal rights to fertilized eggs — a law so far-reaching that not only would it ban abortion in the state if Roe v. Wade is overturned, reproductive rights groups say it could ultimately mean the criminalization certain types of birth control, including IUDs and the morning after pill.

Birth control is back in the spotlight as Supreme Court Justice Kennedy announced on Wednesday that he will retire at the end of July 2018. This opens the door for a new Supreme Court Justice who will help shape important legal decisions as well as potentially rewrite old ones – including those around women’s health and reproductive rights.

We saw this happen last November, when the Trump administration made changes to the Affordable Care Act (ACA). Under the ACA, all health insurance plans had previously been required to provide full coverage for all forms of birth control, but now exemptions are allowed based on religious and moral beliefs. Regardless of your views, here’s information on the available birth control options to help plan for the upcoming years if you don’t have health insurance or think you may lose it.

The pill

  • What is it? Also called oral contraceptives, the pill is the most popular form of hormonal birth control. One pack contains a three- or four-week schedule of pills with varying strengths of estrogen and progestin.
  • Effectiveness: 91%
  • Pros:
    • Most affordable hormonal birth control, even without insurance
    • Unnoticeable and won’t get in the way of spontaneity
    • Can be used to regulate or control periods
    • Side effects vary between brands, so if one doesn’t work you can try another
  • Cons:
    • You have to remember to take it every day
    • Choosing from over 200 brands can be confusing at first
    • Pills with estrogen are not suitable for breastfeeding women
  • Price per month: As low as $4 with GoodRx
  • How to save: Ask for a generic version of the pill (70-80% cheaper than brand-name), and check GoodRx for discounts.
  • Popular brands: tri-previfem, orsythia, junel FE 1/20, camila

The patch

  • What is it? The contraceptive patch sticks to your skin and releases estrogen and progestin hormones into your body.
  • Effectiveness: 91%
  • Pros:
    • Only needs to be replaced once a week for three consecutive weeks
    • Unnoticeable and won’t get in the way of spontaneity
    • Can help regulate periods and clear up acne
  • Cons:
    • There’s only one brand available, so it can be expensive
    • Requires backup birth control if placed after the first 24 hours of your period
    • May peel off if not applied properly
    • Less effective for women over 198 lbs.
    • Not suitable for breastfeeding women
  • Price per month: As low as $95.56 with GoodRx
  • How to save: GoodRx can help you save up to 37% off the average retail price, but if it’s still too expensive, it may be worth visiting a family planning health center to learn about other payment options.
  • Brand: Xulane

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The ring

  • What is it? The contraceptive ring is a small, flexible ring that releases progestin into your body. It needs to be inserted into the vagina in order to work.
  • Effectiveness: 91%
  • Pros:
    • Only needs to be replaced once a month
    • Unnoticeable and won’t get in the way of spontaneity
    • Periods usually become lighter and shorter after the first few months and may stop altogether if used continuously
    • Can help clear up acne
  • Cons:
    • There’s only one brand available, so it may be expensive
    • You have to be comfortable inserting it and taking it out
    • Requires backup birth control if inserted after the first 24 hours of your period
    • May fall out (rare, but it happens)
    • Some people may feel it during sex (but you can take it out for a maximum of three hours within 24 hours)
    • Not suitable for breastfeeding women
  • Price per month: As low as $162.35 with GoodRx
  • How to save: GoodRx can help save up to 12% on average retail price, but if it’s still too expensive it may be worth visiting a family planning health center to learn about other payment options.
  • Brand: Nuvaring

The shot

  • What is it? The “Depo” shot is a progestin injection that has to be taken every three months.
  • Effectiveness: 94%
  • Pros:
    • Available as an affordable generic
    • Only needs to be administered once every three months
    • Unnoticeable and won’t get in the way of spontaneity
    • Periods usually become lighter and shorter after the first few months and may stop altogether
    • Safe to use while breastfeeding
  • Cons:
    • Not for people who are afraid of needles
    • Requires an appointment every three months unless you do it yourself at home (may cost up to $150/visit)
    • Common side effects include heavy bleeding and weight gain in the first six to 12 months
    • Fertility may take up to nine months from your last dose to return
  • Price per month: As low as $13.38 with GoodRx ($40.13 per three-month dose)
  • How to save: Ask for the generic (80% cheaper than brand Depo-Provera) and use a GoodRx to save up to 62% off of the average retail price. If you need help administering the shot, doctor’s visits may be expensive so it might be worth going to a family planning health center to see if they can do it at a lower cost or even for free. They may also have other payment options for you.
  • Brands: generic medroxyprogesterone, Depo-Provera

The IUD

  • What is it? Short for intrauterine device, the IUD is a small T-shaped device that needs to be professionally inserted into the uterus. Plastic IUDs contain progestin that is released over time, while non-hormonal copper IUDs are toxic to sperm.
  • Effectiveness: 99.2%-99.8%
  • Pros:
    • Can last five to 12 years (depending on the brand)
    • Unnoticeable and won’t get in the way of spontaneity
    • Periods usually become lighter and shorter after the first few months and may stop altogether.
    • Safe to use while breastfeeding
    • Fertility returns immediately after removal (copper IUDs only)
  • Cons:
    • Requires an appointment for insertion or removal (may cost up to $300/visit)
    • Not recommended for women with frequent infections
    • Irregular bleeding can occur in the first three to six months
    • Some people may feel the strings during sex at first
    • Can potentially tear through the uterine wall
    • Fertility may take up to four to six months to return after removal (plastic IUDs only)
  • Price per month: As low as $7.24 (upfront cost of $1,043 and lasts for 12 years)
  • How to save: Family planning clinics may offer IUDs and insertion/removal procedures at a lower cost or even for free. They may also have other payment options for you. The Liletta IUD costs $50 at some public health clinics under the 340B Drug Discount Program.
  • Brands: Mirena, Skyla, Liletta, Kyleena, ParaGard

The implant

  • What is it? The implant is a short plastic rod that goes under the skin of your upper arm and releases progestin over time.
  • Effectiveness: 99.95% (it’s the only birth control method where effectiveness in typical, everyday use is the same as “perfect use”)
  • Pros:
    • Lasts up to four years
    • Unnoticeable and won’t get in the way of spontaneity
    • Periods usually become lighter and shorter after the first few months and may stop altogether
    • Safe to use while breastfeeding
    • Fertility returns almost immediately after removal
  • Cons:
    • Requires an appointment for insertion or removal (may cost up to $300/visit)
    • May cause irregular bleeding in the first three to six months
    • You need to be comfortable with the insertion and removal process and the idea of having an implant that you can feel in your arm
  • Price per month: As low as $9.38 (upfront cost of $450 and lasts for 4 years)
  • How to save: Family planning clinics may offer birth control implants and insertion/removal procedures at a lower cost or even for free. They may also have other payment options for you.
  • Brands: Nexplanon

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  • The Trump administration released two final rules earlier this month that broaden exemptions for birth control coverage in employer-sponsored insurance plans, allowing even more companies to decide not to cover medication on religious or moral grounds.

    Under the Affordable Care Act, all employers are required to cover at least one form of every FDA-approved birth control method in their insurance plans at no cost to the patient. That mandate was loosened a bit in 2014 when Hobby Lobby sued the U.S. government, claiming that covering contraception went against its values as a Christian company. The Supreme Court ruled in favor of Hobby Lobby in 2014, arguing that requiring contraception to be included in the health insurance plans of religious-based corporations was a violation of religious liberty.

    Now, Trump’s rules on the subject, which are essentially identical to those first introduced last year but are now final, broaden that exemption. One rule allows essentially any company with “sincerely held” religious beliefs (such as churches, religious institutes of higher learning, or for-profit companies with religious beliefs) to exclude contraception from its health insurance coverage, thus requiring employees to pay for them out of pocket. The second allows small businesses and nonprofit companies to claim a non-religious moral conviction to exempt them from the mandate as well.

    The ACA mandate currently covers any FDA-approved forms of contraception, including pills, IUDs, implants, and emergency contraception. Under these rules, a company could object to covering those FDA-approved methods on moral or religious grounds. In the case of nonprofit religious organizations or companies seeking an exemption on the basis of nonreligious moral convictions, they may voluntarily take advantage of an accommodation, according to the U.S. Department of Health and Human Services. This would allow them to continue to provide some or all contraceptives to their employees without requiring them to pay a copay, co-insurance, or deductible (if provided by an in-network provider), but it would be their insurer’s or a third party administrator’s responsibility to actually do so.

    Basically, the federal government is opening the door to allow more employers to decide whether or not they’ll provide insurance coverage for birth control.

    “It allows virtually any employer with a religious or moral objection to exempt birth control,” Audrey Sandusky, advocacy and communications director at the National Family Planning and Reproductive Health Association, tells SELF. She expects people who use all types of birth control—including the Pill, IUD, shot, and implant—to potentially be affected, possibly unable to afford their contraception. “What we’re talking about writ large is access to all contraceptive methods, which is what the requirement covers,” Sandusky says.

    However, that doesn’t mean that you’re necessarily going to get hit with the full price of a pack of birth control pills next time you’re at the pharmacy. But it does mean that, if the rules go into effect and you work for a company or nonprofit that’s exempt from the mandate, contraception may no longer be listed as a covered benefit the next time you’re shopping for insurance. (As mentioned above, your company may elect to take advantage of an accommodation that would still allow them to provide birth control to you at no out-of-pocket cost via a third party, but it’s entirely voluntary.)

    The Trump administration predicts the change will only affect about 200 employers, impacting about 6,400 women (and no more than 127,000 women) across the country. Reproductive health experts, on the other hand, are skeptical.

    Advocates say it’s particularly cruel to potentially take away benefits just as millions of Americans are adjusting to having health insurance for the first time.

    The Affordable Care Act caused a record number of Americans to gain health insurance by requiring more employers to offer health insurance, creating government-run health insurance marketplaces and expanding Medicaid eligibility. “It could leave an untold number of previously insured women in the dark. Depending on how many employers decide to do this, insured people could see their coverage rescinded,” Sandusky says.

    Thanks to the health care law, most health insurance plans must cover all FDA-approved birth control methods and other important women’s needs without out-of-pocket costs, including female sterilization, birth control counseling, breastfeeding supplies and counseling, and well-women visits. Use our information below to find out if your insurance company is incorrectly charging you and how to talk to them about it.

    • I still have to pay out-of-pocket for my birth control.
    • I was told my health plan only covers generic birth control at no cost to me, but I don’t use a generic.
    • I’m having problems with insurance coverage of the Ring or the Patch.
    • I’m having problems with insurance coverage of an IUD (Mirena, Skyla, Liletta ParaGard) or a related doctor’s appointment.
    • I’m having problems with insurance coverage of the implant or a related doctor’s appointment.
    • I’m having problems with insurance coverage of Essure, a tubal ligation or a related doctor’s appointment.
    • I’m having problems with insurance coverage of my birth control because my employer or school objects to covering it.

    Also, you can contact us at CoverHer.org or 1-866-745-5487 for free help on getting no-cost birth control.

    For more information about this part of the health care law and all the health services for women that health plans are required to cover, go to NWLC’s website: www.nwlc.org/preventiveservices.

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