Birth Control, Conscience, and Choice

Several groups on the left have gotten upset over the fact that Donald Trump is rolling back the “free birth control” clause of the Affordable Care Act. Theoretically, that’s justified, since millions of women have been taking advantage of the program. How many of those millions honestly couldn’t afford birth control in the first place is probably up for debate.

Also, it’s debatable whether or not the new battle front for these groups should involve petitioning for the FDA to allow some more birth control options to end up available over the counter. (Don’t expect to see that, even though it theoretically would make the pill available to more women, because if it’s over the counter, there wouldn’t be any subsidies through any kind of prescription coverage.)

But, no matter what, it’s disingenuous to suggest that great numbers of women who want to use birth control will no longer be able to have it because their employers refuse to pay for it. Before the birth control mandate, birth control was generally treated like any other prescription, which meant that prescription drug coverage partially subsidized the cost of the pills. Without the mandate, it’s fairly safe to assume that it will go back to that standard. Also, insurance companies aren’t going to be forbidden from offering birth control coverage directly to women, even those who are employed by companies that do not want to pay for the drugs. Remember, the issue is about companies not wanting to pay for a particular type of coverage, not forbidding women from having that coverage on their own.

These organizations that are upset about this would be better served by starting to cut deals with the birth control manufacturers themselves, and make coupons or other discount programs available to women who can’t afford the full cost of birth control themselves. (Again, this number isn’t as high as they would have people believe, thanks to multiple generic options.)

If they were really serious about increasing access for women, they would be asking pharmacies with clinics to start offering birth control services.

The primary problem with this issue is that people are focusing on the emotions, as opposed to the money. The bottom line remains that insurance companies didn’t complain about this mandate in the first place because keeping women on birth control is cheaper for them than covering care for pregnant women or women who would have other health problems if they did not take birth control. Insurance companies will find a way to keep the status quo, because it has been helping their balance sheets at least a little. The same goes for the pharmaceutical companies manufacturing the drugs. If anyone believes that they will easily give up their sales over this, they need to rethink their position.

If we’re lucky, the solution to the issue will involve removing both government and employers as brokers between women and access to birth control. Maybe it’s time for women to stop demanding that employers and government hand them their pills, and start demanding better options directly from insurers and pharmaceutical companies?

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