I’m what they call a “woman of childbearing age,” which means that every day, my ability and choice to or not to procreate is on my mind.
So when the current administration removed the contraceptive coverage mandate from the Affordable Care Act this month, I was reminded of the role birth control has played in my own life – from sourcing and using it to paying for it.
My relationship with birth control began when I was a student. Planned Parenthood gave me both high quality, personal health care and a prescription for birth control pills. I didn’t have much income, and the pills cost me nothing. Now I make it a point to support those same services so other young people will have similar access to care.
It might surprise those who’ve never taken birth control to hear that people react differently to different kinds – and it’s critical to find the right fit. Twice, I had to ask doctors for alternatives, because the hormones I was taking made me foggy and sad and I feared I was becoming depressed.
An IUD might have been a better choice, but before the mandate, at five to eight hundred dollars, it was cost prohibitive. I’d started working full time, but my employer’s insurance didn’t cover birth control and in comparison, the out of pocket cost of pills was just forty dollars a month.
I say ‘just’ but at the time, half my salary was going toward rent, and the rest had to cover everything from student loans to food, so forty dollars a month was significant. Still, I considered myself lucky since I was educated about my options, and never had to choose between buying birth control and paying for some other necessity.
Cutting the contraceptive coverage mandate is usually framed as a church and state issue, but I think it’s primarily one of economic justice. Women earn roughly 20% less than men, and the cost of contraception is a gender-specific burden. Now, many women will again have to choose the contraception they can afford over the one that’s right for them – never mind that for some, just a monthly trip to the drugstore is time and transportation-prohibitive.
And this, to me, illuminates the absurdity of America’s employer-based health benefits in the first place. With universal Medicare, the health benefit cost for businesses would disappear and all our contraception needs could still be covered.