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Worried About Birth Control Access? Here's What You Should Know

Different contraception techniques.

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Key Takeaways

  • A July Supreme Court ruling and an upcoming hearing on the Affordable Care Act could impact access to contraception without cost-sharing.
  • Despite threats to mandated contraceptive coverage, individuals may be protected by state laws, employer insurance plans, or have access to other low-cost options.
  • Contraceptive methods vary widely on effectiveness in preventing pregnancy, side effects, duration of protection, and more.

On October 26, Justice Amy Coney Barrett was confirmed to the Supreme Court amidst outcries from reproductive rights advocates. Now the sixth conservative justice on the bench, Barrett could be decisive if there is an opportunity to overturn the precedent of Roe v. Wade, the landmark ruling that protects a woman’s right to choose to have an abortion without government restriction. 

“Justice Barrett’s academic writings, court decisions, and public advocacy reveal a legal view that the U.S. Constitution does not protect an individual’s personal liberty to make decisions about their reproductive health,” Nancy Northup, president and CEO of the Center for Reproductive Rights, wrote in a statement following Barrett’s confirmation.

Barrett’s confirmation comes at a time when access to reproductive healthcare is being questioned from multiple angles. In July, a Supreme Court decision in the case Little Sisters of the Poor v. Pennsylvania upheld President Donald Trump's administration rules exempting for-profit religious organizations from providing contraceptive care under the Affordable Care Act. 

The Trump administration predicted that roughly 126,000 people would lose access to birth control coverage due to the ruling. According to Mara Gandal-Powers, director of birth control access and senior counsel at the National Women’s Law Center, it will actually likely affect access for several hundred thousand people.

“Access to birth control and access to the full range of reproductive health care is so critical, not just for our health, but also for our ability to determine our futures; our ability to achieve our goals at school and work, with the size our family and our finances,” Gandal-Powers tells VeryWell. “To be able to time and space our pregnancies is so critical.”

After the confirmation, many took to social media to express their worries over access to affordable contraception. Differing advice emerged on everything from seeking long-term birth control options to how to store extra emergency contraception. Here's what experts actually recommend you do to prepare and stay protected.

What This Means For You

If you are worried about your birth control coverage, talk with your medical provider about your options. Depending on rules in your state, birth control may still be covered with no out-of-pocket costs even if federal rules change. If you’re uninsured or your insurance no longer covers contraception, you may also receive care at low-cost family planning clinics, your state’s health department, or through companies that offer mail-order options. 

Protections Under the Affordable Care Act

On November 10, the Supreme Court will begin hearing arguments on two consolidated cases questioning the validity of the Affordable Care Act (ACA). 

Under the ACA, birth control is considered preventative care. As such, it must be covered by all plans in the Health Insurance Marketplace without a copay or coinsurance. The National Women’s Law Center estimates that as of September 2017, the ACA allows contraceptive coverage without out-of-pocket costs for more than 62 million people. To ensure these protections in the future, the Supreme Court will have to rule that the ACA is valid.

Depending on this decision and the outcome of the presidential election, reproductive rights advocates expect restrictions on and funding for reproductive health services to change. 

“We are either going to be in a situation where there are further attacks and further eroding of access, or we’re going to be going into clean up mode and trying to improve access again,” Gandal-Powers says. 

Even if the ACA is struck down in the Supreme Court, people seeking contraception may still receive coverage through state and some federal rules, Gandal-Powers says. Sixteen states and the District of Columbia have laws that mirror or improve upon the ACA by offering full coverage of FDA-approved contraceptive options without cost-sharing. In other states, some laws require prescription contraceptives to be treated like other prescription drugs, offering some level of protection. 

Without a national health care option, people are often left to the will of their employer-provided insurance or state laws. 

“This is why the ACA was so important,” Gandal-Powers says. “Without it, it’s a patchwork and it’s really hard to know what applies to your coverage and you may still have cost-sharing.”

Receiving continuous contraceptive care is especially important for methods like the IUD and implant. For these, the ACA covers the cost of the device, the insertion, and the removal process. Without these protections, if someone receives an IUD, for example, and then needs it removed years later when they no longer have birth control coverage, they may face unexpected costs. 

Choosing the Right Method

Shifting rules around reproductive health insurance can leave people confused about their options. At multiple times throughout the Trump presidency, conversations about birth control access have taken off in online communities. On social media platforms like Instagram, TikTok, and Facebook, users are sharing their views on healthcare policies and information about birth control options. 

Nicole Sparks, MD, an OB-GYN in Atlanta runs a medicine and lifestyle blog as well as multiple social media accounts under the handle, nicolealiciamd. She says she uses her platform to reach women with reproductive health questions like young women who are nervous to ask their parents for information or are curious if their bodily functions are “normal.”

“It’s really important for us to get really accurate health information out there because people will be Googling what they want anyway, so if you have physicians who are in the field and putting out evidence-based information, I think that is really good,” Sparks says. “I can only see 20 or so patients a day, but I can reach thousands or millions of people by putting out a 15- or 30-second video on TikTok, which I think is amazing.”

In her videos, Sparks uses songs and dances to explain topics like the different benefits of oral contraceptive pills, what happens during ovulation, and how clinicians insert IUDs. While her social media presence can’t act as a replacement for visiting a medical professional, she says she can dispel common misconceptions and encourage people to find the right solution for their own birth control needs.

Your Options

“We have so many options—10, 15, 20 options—so I feel it’s our job to present those options and a woman’s right to choose whatever option works best for her budget, her life and her family,” Sparks says. 

The aftermath of Barrett’s confirmation hearing and the July ruling incited chatter about getting IUDs from young people online. Because hormonal IUDs last for between three and seven years, that may be a good method for people who want long-lasting protection. 

Sparks recommends that people who are concerned about pregnancy keep a small supply of emergency contraceptive pills on-hand, in case of unprotected sex. However, if they find themselves using it often, they should consider another option. 

Certain non-hormonal birth control methods can typically be purchased over-the-counter at drugstores or online. These include condoms, a birth control sponge, cervical cap, diaphragm, and spermicide. Though they can be less expensive for those who have sex infrequently, they are also less effective at preventing pregnancy than hormonal methods like the IUD and the pill. 

What This Means For Contraception Coverage

Following the July Supreme Court ruling and looking ahead to the ACA hearing, mandated birth control coverage from employer insurance plans may become undependable. Gandal-Powers says there is no “master list” of employers that object to birth control coverage for job-hunters to consult when choosing a job. That’s why it’s important to learn about ways of receiving birth control at low costs. 

Health care providers may be able to offer coupons to reduce the cost of certain methods or support you by calling different pharmacies to help you find the best price. 

“If something changes with your policies, or if you can’t control your birth control, I always tell people to talk to their provider because usually we can find a way around it or make it more affordable for you,” Sparks says.  

For those who find scheduling an office visit to receive a prescription to be undesirable or unfeasible, some companies offer birth control options delivered to your door. Companies like Nurx and Pill Club employ nurse practitioners and physicians who can write birth control prescriptions, and they accept many forms of insurance to minimize or eliminate out-of-pocket costs. 

Family planning clinics like Planned Parenthood also offer low-cost contraceptive options. Still, with federal funding cuts to these services, people who rely on them may face higher barriers to care like difficulty securing transportation to far-off clinics. 

“There definitely has been a lot of chatter about IUDs and people stockpiling emergency contraception and that kind of stuff, and that’s not the right solution for everyone,” Gandal-Powers says. “People need to really dig in on ‘what are the real threats to me’ and if they find out that the real threats are not to them, think about the folks to which the threats really are happening and how they can support those people to make sure everyone still has choices around their birth control options.”

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Article Sources
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  1. Center for Reproductive Rights. Center for Reproductive Rights statement on the confirmation of U.S. Supreme Court Justice Amy Coney Barrett. Updated October 26, 2020.

  2. Supreme Court of the United States. Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania. Updated July 8, 2020.

  3. Physicians for Reproductive Health. What is Title X? an explainer.