Patient Access to Contraception

Questions for the Candidate:  Do you support federal funding of contraceptives? Does this include emergency contraception? Do you support the requirement that insurers provide coverage for contraception?

In recent years, several attempts have been made to limit access to birth control, including the Supreme Court’s Hobby Lobby decision, cutting Title X family planning funding and ending Medicaid coverage of Planned Parenthood’s preventative services.

Did you know: The year after Texas decreased funding to family planning clinics, use of long-acting reversible contraception (LARC) decreased by 35%, injectable contraception decreased by 31%, and Medicaid births increased by 25%.   

Patient Access to Contraception - Federal

Title X

ACOG supports federal funding for Title X of the Public Health Service Act.  Title X is the only federal program devoted specifically to family planning services, through 4100 community-based clinics nationwide. This vital program regularly appears on the federal budget chopping block.   Cutting Title X family planning would increase spending over the long run; studies show that every $1 spent on family planning saves tax-payers $5.68.

Hobby Lobby Decision

In its July 2014 Burwell v. Hobby Lobby decision, the US Supreme Court allowed certain for-profit corporations to opt-out of the ACA’s requirement of employer coverage of contraceptives based on the corporation’s religious beliefs. ACOG as well as other medical organizations filed an amicus brief in support of the coverage mandate. ACOG supports the Affordable Care Act (ACA) employer mandate, ensuring women access to contraceptive care with no co-pays, regardless of state of residence, employment, or marital status.

Ending Medicaid coverage of Planned Parenthood’s preventive and contraceptive services – ‘Defunding Planned Parenthood’

Several attempts have been made to cut Planned Parenthood out of the Medicaid program.  The Congressional Budget Office, which analyzes the effect of legislation on the federal budget, analyzed the Defunding Planned Parenthood bill and found that “as little as 5 percent or as much as 25 percent of the estimated 2.6 million clients served by Planned Parenthood would face reduced access to care.”  And that “the number of births in the Medicaid program would increase by several thousand.

The Centers for Medicare/Medicaid Services warned State Medicaid Directors not to block Medicaid patients’ ability to receive non-abortion family planning care at Planned Parenthood clinics, as it would limit patients’ freedom to choose their providers, a basic Medicaid program rule. 

Patient Access to Contraception - State

Ensuring Insurance Coverage of Birth Control

Some state laws require insurance plans to cover contraception. The Hobby Lobby decision only applies to federal law; it does not change any existing state law. To read more on how the Hobby Lobby decision affects your state, click here.

To see a summary of your state’s laws on insurance coverage for contraceptives, see page 3 of this Guttmacher Report.

Access and cost problems are common reasons why women either do not use contraception or have gaps in use. Many insurance restrictions prevent women from receiving more than a single month’s supply of contraception at a time, although this has been shown to significantly limit a woman’s likelihood of obtaining the necessary refills on a timely basis. ACOG supports coverage of a 3 – 13-month supply of contraception.

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Funding Planned Parenthood

Many efforts have been made to limit funding to Planned Parenthood and other family planning services. State legislation to limit Medicaid, along with other funding to any agency that provides abortion services, ensures that common preventive measures (e.g. cancer screenings, and intimate partner violence prevention) cannot be provided to women most in need of these services. 

States that have proposed such legislation, include:  Arizona, Iowa, Kentucky, Louisiana, Michigan, Mississippi, Missouri, New Hampshire, New York, South Carolina, and Washington. Both Florida and Ohio have already enacted similar legislation. 

Similarly, there are efforts to completely eliminate funding to any agency that also provides abortion services. Five states: Illinois, Minnesota, Pennsylvania, Virginia, and Wisconsin, have proposed such measures, while Wisconsin currently has a law in place.

Texas shows the detrimental effects that defunding Planned Parenthood can have on women’s access to family planning services and the unintended pregnancy rate.  The year after Texas cut Planned Parenthood out of the state budget, use of long-acting reversible contraception (LARC) decreased by 35%, injectable contraception decreased by 31% and Medicaid births increased by 25%. Click here to read the New England Journal of Medicine summary.

To read more about what is happening with family planning funding in your stateclick here.

Talk to your Member of Congress, public office candidates or local representatives, about how important contraception is to your patients by clicking here.

To read more on ACOG’s support for patient access to contraception, click here. And to see the latest legislation in your state, click here.


 

American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998