By Elly Kosova
When NWHN’s Policy Advocacy Director Sarah Christopherson was invited to speak at a Women’s Health Magazine panel on contraceptive access, she eagerly accepted, excited to talk to young women about their options. A few days before the event, she emailed me about a new research assignment.
I think of myself as a pretty prepared person. I run an active Google calendar, carry around two extra pens at all times, and am subscribed to more political newsletters than I have fingers. By the time Sarah made her way to my desk, I was ready to go, with facts about copper versus hormonal IUDs, anecdotes about the pill, and statistics about the diaphragm. I was recounting a particularly interesting fact about spermicide when Sarah’s actual research question burst my bubble:
“How much do all of the different kinds of birth control cost without insurance?”
This is a question that women all over America are being forced to answer in a real way in light of recent events. And unfortunately, like me, many of them are also drawing a blank.
When the Trump administration released two new rules to roll back the Affordable Care Act’s contraceptive mandate, it opened the door for millions of employers to claim religious or moral exemptions from providing birth control. And, as expected, some employers have been quick to snatch back their coverage of contraceptives, abandoning women who depend on their insurance to afford them. Notably, the University of Notre Dame initially claimed religious exemption from the birth control mandate. For the female employees, students, and dependents covered by the Notre Dame health plan, the thought of paying for birth control without the help of insurance instantly changed from an absurdity to a necessity.
As I began my search, I realized just how disconnected from the reality of birth control prices I was. In my own life, discussions about starting prescription medication went hand-in-hand with discussions about insurance. I knew that the small co-pays I was making were not close to the prices these medications would be without insurance…but I didn’t know by how much.
Soon, I had a spreadsheet full of alarming numbers. Implants, such as Nexplanon and Implanon, cost over $800 each. Intrauterine devices, such as the Mirena and ParaGard, cost over $1,000 each. However, the implants and the IUDs lasted for multiple years. While the cost of birth control pills is around $20 to $50 per individual pack, monthly purchases added up to a yearly sum of anywhere from $240 to $600. The $60 Depo-Provera shot comes in at a total of around $240 per year when accounting for follow-up injections every three months, and the $100+ NuvaRing comes in at a total of $1,000 per year when factoring in its five-week turnover rate. And, of course, these costs don’t include the cost of a contraceptive counseling appointment with a health provider who can prescribe them. With each new calculation I could feel my palms getting sweatier.
Devastatingly, these new birth control rules do more than just ransack women’s pocket books. They threaten women’s basic rights over their own bodies.
However, amid attacks on their reproductive choices, women are choosing to speak out. After an enormous backlash, the University of Notre Dame reversed their decision and decided to continue to provide coverage of contraception. The University of Notre Dame is not the last battleground in the fight for access to affordable contraceptives. But, if we keep banding together to fight for the reproductive care that women deserve, we will continue to have more victories.