Birth Control Coverage Benefit Isn't Mandated if Company Objects

Employers can refuse to include birth control in their employee health insurance plans.

The Supreme Court decision issued on July 8, 2020, upholds regulations advanced by the Trump administration in 2018 that allow virtually any employer, including universities, hospitals, small businesses, and large corporations, to cite either religious or moral reasons not to cover their employees’ contraceptives.

The New Birth Control Rule Is Already in Effect

的决定,立即生效,是expected to affect between 70,000 and 126,000 women who have relied on the Affordable Care Act (ACA) for free birth control, according to theWashington Post.

The ACA’s birth control benefit, introduced in 2012, “expanded contraceptive coverage with no out-of-pocket costs for more than 62 million women, including 17 million Latinas and 15 million Black women,” according to apress releasefromAlexis McGill Johnson, the president of the Planned Parenthood Action Fund.

“The ruling is a devastating hit to women’s health,” saidGillian Sealy, PhD, MPH, the CEO ofPower to Decide. “Women across the country will now have to worry that depending on where they work, the insurance plan they pay for may not provide them with access to the contraceptive care they need and that is right for them. The ruling also makes contraception too expensive for some women to afford, and studies confirm that cost is a major determinant of whether people are able to obtain the contraceptive method that is right for them.”

的一个子集依赖避孕的女性没有even use it for birth control. Instead,birth control pillscanhelpregulate periods, minimize cramps, manageendometriosisandpolycystic ovary syndrome (PCOS)symptoms, and reduce the risk ofsome cancers.

A group of federal House and Senate lawmakers immediately filedlegislationto repeal the Trump administration rule, but what does this decision mean for women right now?

1. You May Have to Spend More on Birth Control

If you work for an employer who cites a religious or moral objection to contraception and have relied on your employer-provided insurance to get free birth control, “the plan you pay for will no longer cover birth control, and you should be on the lookout for a notice from your insurance plan informing you of such,” Dr. Sealy says.

Pay attention to any paperwork your insurance plan sends you, and if you have questions or issues about birth control coverage through your insurance plan, consult a website such asCoverHer.orgto see what your options are, she says. If you want to talk to your employer about how this decision will affect you and to educate them more about the issue,Bedsider offers some practical advice .

2. Cost Shouldn’t Dictate Which Birth Control Is Best

There are more than a dozen different ways to prevent pregnancy, and “no single birth control method is right for everyone,” said Krishna Upadhya, MD, MPH, a senior medical adviser at Planned Parenthood Federation of America. “The more safe, effective methods there are for people to choose from, the better.”

Different factors to consider, besides cost, when choosing a contraceptive include

Accessibility
Ease of use
Potential side effects
Privacy
Yourreproductive plans
Yourmenstrual cycle
Your risk of getting asexually transmitted infection (STI)
How important it is for you to prevent pregnancy

These factors change throughout a woman’s life, said Sealy. “The median number of methods ever used by women in the United States is about three, but nearly one-third of women have used five or more methods. Different people need different methods; that is why it is important thatallmethods be covered without cost-sharing.”

3. Costs Can Vary Due to Long-Term Contraception Use

While it may appear that certain methods — such as condoms, sponges, diaphragms, patches, or birth control pills — cost less out of pocket, they may end up costing more over time. “In fact, long-acting reversible contraceptives such as the IUD (intrauterine device) or birth control implant may be more cost-effective than initial lower-cost options after a couple years of use,” Dr. Upadhya says.

Obtaining many forms of contraception, including IUDs and implants, requires at least one visit to a healthcare provider’s office to get a prescription or insertion.Planned Parenthoodis offering some aspects of provider visits for IUDsvia telehealthbecause of thecoronaviruspandemic, and is doing what it can to shorten in-person visits to reduce potential risk ofCOVID-19exposure for both patients and health center staff, sincesocial distancingis still necessary as the pandemic persists.

“These visits are not always necessary, and for some women they are a significant burden,” Sealy says. “For some, the cost of transportation, unpaid time off from work and childcare can make acquiring contraception cost-prohibitive. Also, the most effective contraceptive methods, which include IUDs and implants, can cost hundreds of dollars or even more up front. In fact, without insurance, many women would need to pay more than $1,000 to start using one of these methods. The benefit, though, is that they can be used for years. If someone can afford the upfront cost of an IUD, then uses it for 12 years, it would be a cost-effective method.”

To help you compare the costs, effectiveness, and other details of differentbirth control methods, theBedsider Method Explorerhas comparative charts online.

4. The Supreme Court Decision Predominantly Affects BIPOC, Poor, Rural Women

In rural areas, there are typically fewer businesses to choose from as employers for the residents who live there. Teleworking or remote jobs may be difficult to find. The pandemic has contributed to historic job losses (and the subsequent loss of employer-based health insurance) and furloughs. In this kind of economic landscape, limitations onbirth control accessaffect impoverished people and women in the Black, Indigenous, and People of Color (BIPOC) populations more directly.

“The result of this ruling will be to deny women access to basic reproductive healthcare, and the burden will once again fall most heavily on women of color, women living in rural areas and women with limited means,” says Sealy. “This decision also represents one more barrier for Black women whose health is already disproportionatelyimpacted by systemic inequitiesthat further limit their access to critical reproductive healthcare services.”

Similarly, “the decision will only make life harder for the very people who are keeping our economy afloat during this pandemic and fighting in the streets for the right to control their bodies and lives,” said McGill Johnson.

5.You May Need to Find a New Place to Get Birth Control and Emergency Contraception, if Your Insurance Won’t Cover It

Look intoBedsider’s list of companies that will deliver birth control, as well asemergency contraception, to your door. Prices listed are accurate as of April 2020, but do your research and find out directly from each company what your specific out-of-pocket cost will be.

Emergency contraception is a way to prevent pregnancy up to five days after unprotected sex. Levonorgestrel pills (known commercially as the brandsPlan B One-Step,Next Choice One Dose, and others), can be bought over the counter at a drugstore, or online, as well as from some healthcare clinics. Another pill, Ella, is prescription-only and can be filled at a drugstore, clinic, or online. You can also have a copper IUD inserted into your uterus within five days of unprotected sex, but it requires a visit to a healthcare provider. Some pills are only effective for up to 72 hours, while others can be used up to 120 hours after sex. Weight plays a role with emergency contraception; according to Planned Parenthood, certain pills are not effective ifyour body mass index (BMI)is over 25 or 30; whereas the IUD is most effective for women of all sizes.

Regardless of the reason it is needed, birth control “is basic healthcare women need to stay healthy and live their best lives,” Sealy says. In an independent telephonesurveyconducted in September 2019 for Power to Decide, a majority of adults in the United States said that they believed that birth control should be considered a basic part of women’s healthcare.

CORRECTION: The previous version of this story suggested that Obama-era regulations were challenged in this case. The regulations challenged were issued by the Trump administration. Everyday Health regrets the error.