Threatening access to affordable contraceptives and people will take action. But what does this mean for you in the coming years?
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Women switched to long-acting contraceptives in late 2016
After the 2016 US presidential election, when Donald Trump was elected and pledged to repeal and replace the Affordable Care Act (ACA) with its mandate for free or inexpensive access to birth control for women, the number of women who began using intrauterine devices (IUDs) and implants, known as contraceptives Long-acting and reversible (LARC) pregnancy, increased significantly.
Why did interest in LARC increase dramatically after the 2016 elections?
in search letter Published on February 4, 2019 in the magazine JAMA Internal MedicineIn the study, researchers found that there was a 21.6 percent increase in women with commercial insurance who obtained LARCs (either IUDs, such as Mirena or Paragard, or an implant, such as Nexplanon) in the 30 days after the 2016 presidential election, compared to rates in the previous 30 days. for the elections. LARC introduction rates remained roughly the same for the same time period in 2015.
Affordable and cost-effective long-acting birth control
Long-acting contraceptives are very effective in preventing pregnancy; It can be used for up to 12 years without the need for replacement. With the Affordable Care Act in place since 2012, average IUD costs have fallen from $40 to $0, note the researchers, who followed nearly 3.5 million women with private health insurance to determine LARC use. An IUD can cost up to $1,300 when paid for out of pocket and is not covered under the ACA’s mandates, Planned Parenthood notes.
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Are the benefits of birth control for American women still at risk?
Trump attempted to remove birth control coverage from the ACA in 2017, but federal courts blocked those efforts. With legislation underway in different states, two court decisions in January 2019 ruled that nationwide access to contraceptives must remain in effect, while state lawsuits move forward to determine whether employers in the larger group can decide removing birth control coverage from their health insurance plans due to an ethical or religious objection, according to Article published on January 14, 2019 in Vox.
What does this mean for women still worried about their access to low-cost or free birth control — especially in the latter half of Trump’s presidency, and in the years ahead should Trump win reelection?
Related: Birth control in America: a brief history of contraception
Next steps for women concerned about losing access to affordable contraceptives
“If you are concerned about birth control, now is the time to talk to your healthcare provider about it,” he says. Mara Gandal Powers, director of access to birth control and senior counselor for reproductive rights and health at the National Women’s Legal Center in Washington, DC. You don’t have to wait until your next appointment for a Pap smear or vaginal exam, which can take a year or more. “Most people still have to cover birth control right now, but it’s clear where this administration is trying to go. I understand why people take political realities into account in their decisions — it’s true.”
US policy and health insurance coverage for birth control
Since the 2016 election, the Trump-Pence administration has tried to scale back current birth control coverage as detailed in the ACA, and has tried to restrict access, said Lena Wynne, MD, president of Planned Parenthood Federation of America. “Our patients were concerned that their access to contraception and healthcare would be at risk under the new administration,” she said in a statement. “The Trump-Pence administration has consistently attempted to cut off access to reproductive health care, including the recent attacks on Title X, the country’s only federal program for family planning,” which includes birth control coverage.
Trump also appointed conservative Brett Kavanaugh to the Supreme Court in October 2018, helping to further the Supreme Court’s right-wing tilt. Gandal-Powers says Kavanaugh and Supreme Court Justice Neil Gorsuch “are not friends with birth control.” And in cases where employers wanted to cut off access to contraceptives for ethical or religious reasons, “they would vote for employers to offer health insurance coverage that didn’t include birth control at all.” Kavanaugh referred to some birth control methods as “abortion-inducing medications,” according to A Article published on September 7, 2018 in Vox.
Birth control advocates saw progress in the 2019 midterm elections
However, the 2019 midterm elections saw more Democrats elected to the US House of Representatives, making it clear that they are “the most pro-choice house in history,” says Gandal Powers. “We know we have great birth control champions in the House and Senate.” Indeed, Alexandria has criticized Ocasio-Cortez, who was elected to the House of Representatives in late 2018 and has drawn the ire of the current president representing her New York state district, Kavanaugh. on Twitterwrote in September before her election: “Brett Kavanaugh doesn’t even know what birth control is. He doesn’t deserve to pass the seventh grade in health, let alone the confirmation of the Supreme Court. I refuse to allow women and LGBT+ to deteriorate. I refuse to live in a less free world.” .
Birth control news, developments since the 2016 election
Since Trump’s election, a new form of birth control has been approved while another has been withdrawn from the market.
Related: Birth Control Resource Center
A new vaginal ring was approved by the Food and Drug Administration in 2018
Annovera (segesterone acetate and ethinyl estradiol vaginal regimen), a combined hormonal contraceptive and long-acting vaginal ring that allows users to wear a flexible plastic ring for three weeks at a time for up to a year of use, has been approved by the US Food and Drug Administration (FDA) ) in August, 2018. While it’s not LARC because it needs to be removed for a week each month, the year of use makes it better than the current Nuva Ring, which requires women to get a new one every month. According to Everyday Health, “Longer-term prescription and less frequent need for refill improves the rate of effectiveness of the birth control method.” Using Annovera for 12 months also avoids the possibility of having to pay for a new device before a year goes by, if birth control coverage becomes an expense for women.
Essure left the market in 2018, a controversial and reversible method of birth control
Essure, a birth control method described as the “closest male vasectomy-like procedure” in an Everyday Health report, was removed from the US market at the end of 2018, after July 2017 announcement by parent company Bayer regarding declining Essure sales. Several patient advocates note that extensive patient reports on Essure’s safety record have also played a role in the decline in sales.
Talk to your doctor about contraception sooner rather than later
Regardless of what the future holds in terms of whether birth control will continue to be covered by the ACA or whether women will be required to pay out of their pocket to use it, experts agree that talking to a doctor or other health care provider is critical, at any time. You have any questions about your birth control method.
Related: What are emergency contraception?
What is the best birth control method for you right now?
“Birth control methods are not one-size-fits-all,” Wen said in a statement. “A method that is right for one person may not be right for another. It is important that each person talks with their doctor or other health care provider about the method that is best for their health and life.”