Access to Contraceptives: A Path Forward

As a woman, a mother, and a doctor, I recognize that the ability to plan if and when to have children is essential to the well-being of all women. In the United States alone, more than 40% of pregnancies — 2.8 million each year — are unplanned. More alarmingly, the women with the fewest financial resources have the highest likelihood of having an unplanned pregnancy, and those women are the most likely to remain uninsured today.

Dr. Jessica GrossmanIn recent years, there has been much progress in addressing this issue. Notably, the Affordable Care Act of 2010 (ACA) has played an integral role in helping women get access to contraceptive services. Under the ACA, health insurance plans are now required to cover 100% of women's preventive health care, including all prescribed FDA-approved birth control methods. This means that insured patients now pay zero dollars out-of-pocket for birth control methods like birth control pills, vaginal rings, and intrauterine devices (IUDs). And more women have access to birth control than ever before.

While the ACA has made great strides in helping women gain access to contraceptive services, more still needs to be done to provide low-cost contraception to all women. Six years after the passage of the ACA, approximately 10 million American women do not have health insurance. Many of these women are living at or below the Federal Poverty Level, are immigrants to the United States, or are living in states that have not expanded Medicaid coverage under the ACA. Some state policies allow employers or insurers to refuse to cover contraceptives on religious or moral grounds.

At Medicines360, we are committed to reaching all women, especially those who fall through the cracks. Our mission is to expand access to quality medicines for women, regardless of their socioeconomic status, insurance coverage, or geographic location. Augmenting ACA's efforts to increase access to birth control, Medicines360 works with clinics and community health centers to make it easier to stock IUDs on their shelves. IUDs in particular address the unplanned pregnancy rate head-on because they are highly cost-efficient, highly effective at preventing unplanned pregnancy, and don't require the added burden of constant prescription refills.

As the United States' concern about the Zika virus grows, our mission has become even more important. Zika is particularly dangerous for developing fetuses, so it is especially important for women to be able to choose to delay pregnancy. Women without health insurance coverage need accessible, effective birth control to help avoid suffering from Zika's worst effects. Women without health insurance who wish to delay pregnancy should know that there are many birth control choices available to them at family planning clinics. These clinics, funded by the U.S. Department of Health and Human Services Office of Population Affairs, are required to provide services to all people. Services to low-income individuals are provided at low or no cost.

With World Contraception Day on September 26, it is important that all women know their contraceptive options. I encourage uninsured women looking to prevent pregnancy to visit a public health clinic and ask their health care providers what contraceptive options are appropriate for them. In addition, women can visit HealthCare.gov to assess their eligibility and enroll in a public health insurance plan. Open enrollment begins November 1, 2016.

Dr. Jessica Grossman, M.D., is the CEO of Medicines360, located in San Francisco, California. Medicines360 is a nonprofit global women's health pharmaceutical company with a mission to expand access to quality medicines for all women regardless of their socioeconomic status, insurance coverage or geographic location. Jessica is committed to reducing the global disparity in the number of unplanned pregnancies and increasing access to highly effective long-acting reversible contraception. For more information, visit www.medicines360.org.

The statements and opinions in this blog post are those of the author and do not necessarily represent the views of the U.S. Department of Health and Human Services Office on Women's Health.