By Jori Hamilton
What is it about a uterus that makes policymakers, insurance companies, and lobbyists so squeamish? After all, 50.8% of people in the U.S. identify as female, and the vast majority of us happen to have a uterus. (Though, a uterus does not a woman make.) Yet, people with uteruses struggle to get the care they need, particularly when it comes to asking their insurance companies to pay for the care needed to keep them healthy.
In 2010, the Affordable Care Act (ACA) signaled the most important step forward in women’s health and public policy since…1965. Ouch. It not only helped more women access health insurance and lowered the cost, but it also required coverage for essential items, like birth control and mammograms.
While the ACA is a game-changer for people with uteruses, it also doesn’t quite change enough of the game. For example, people suffering from infertility are largely left out and struggle to find an individual plan that covers processes like In Vitro Fertilization (IVF). There needs to be full coverage of sexual and reproductive health for all people — uteruses or not.
Birth Control: So Much More Than Pregnancy Prevention
Let’s start with a very basic element of reproductive care: hormonal contraception. Colloquially referred to as ‘the pill,’ the first oral contraceptive was approved by the FDA in 1960. Birth control has come a long way since then, but the general understanding of its importance in people’s lives hasn’t necessarily evolved.
There’s nothing wrong with using hormonal birth control for preventing conception. It’s what it’s there for, and people who have uteruses have the right to choose when they want to get pregnant. However, suggesting that pregnancy prevention is its only use is erroneous. Hormonal birth control also contributes to solutions like:
- Regulating menstrual cycles
- Relieving period pain
- Reducing acne
- Lowering the risks of cancer
- Minimizing symptoms of PMS and PMDD
- Managing endometriosis
- Combating menstrual migraines
For those with reproductive disorders and diseases, birth control is a lifesaver. It helps them go to school and work and pay their bills and generally have a better quality of life that’s not dominated by pain.
At the same time, insurance providers have a love-hate relationship with the pill (and other forms of contraception). Under the ACA, they must cover birth control at full-cost with few exceptions. But as the ACA faces more challenges in the courts, including at the higher level, it’s increasingly unclear if the contraception rules will survive. And the issue has gotten even murkier with the death of Justice Antonin Scalia and President Trump sticking his nose in.
Birth Control Should Be Free Already
Birth control has a lot of uses, and each is unique as the person who takes it. At its core, though, it’s an essential form of preventative healthcare. That’s why birth control should be free, whether accessed through insurance or without it.
According to the Department of Health and Human Services (HHS), there are 62 million people in the U.S. in their childbearing years (aged 15 to 44). Out of those, 70% are at risk of experiencing an unplanned or unintended pregnancy. People typically use contraception for almost a third of their lives — at least. The actual financial cost of this long-term contraception use adds up, and it shows. Unintended pregnancies disproportionately impact lower-income workers and people of color.
By putting a price on birth control either through a co-pay or at a retail pharmacy, people have to choose whether to use hormonal contraception or whether to do other things, like pay their rent, buy food for themselves or their children, or pay their utilities. Those prices are much higher for those on a low-income, but the price isn’t just related to the cost upon purchase. According to a survey, U.S. women said that using birth control allows them to do things like:
- Support themselves financially
- Take better care of their families
- Keep or get a new job
- Finish school
Women Already Suffer Health Inequities
Birth control is an essential part of people’s lives, and it’s also an important part of shoring up equality in healthcare. Health equity is a concept that removes the obstacles that stand in the way of people’s fair chance at achieving good health, impacts people for many reasons, including economic, sociocultural, societal, and environmental. Gender is also a huge issue.
Women suffer serious gender disparities in healthcare in part because of issues like the ‘trust gap,’ or the idea that women’s health symptoms are a form of attention-seeking. The concept harkens back to dated concepts like hysteria, which doctors used to explain anything that didn’t fit into the traditional concepts of medicine.
Making items like birth control (and other reproductive care) free and ideally available over-the-counter empower those who use them to manage their own care. It removes the need to deal with gatekeepers who make them jump through hoops or discount their symptoms as being ‘in their head’ — or worse, making moral judgments when deciding whether or not to provide them with care.
Ultimately, women’s reproductive care is healthcare and the fight over whether to pay for or cover basic elements like hormonal contraception only damages women’s fundamental rights. As we’ve said before, birth control is a no-brainer in preventing unplanned pregnancy and allowing women to control their own health. Providing unequivocal coverage is the absolute least insurance companies can do.
Jori Hamilton is a writer from the Pacific Northwest who covers social justice, politics, education, healthcare, technology, and more. You can follow her work on twitter @hamiltonjori or https://writerjorihamilton.contently.com