My neighbor told me something about his own family planning a while ago when he discovered that I worked at Planned Parenthood. He said that because he and his wife could not afford the high price of contraceptives, she had been getting Depo-Provera birth-control shots at a local flea market. The flea market is certainly not a medical setting, but they didn't know where else she could get contraceptives that the family could afford.
They are not alone. According to a 2010 survey by Hart Research, nearly 60 percent of young Latina women have had difficulty paying for prescription birth control at some point in their lives. Even health insurance co-payments for birth control pills or Depo shots can be as high as $50 per month. For methods such as IUDs, co-pays and other out-of-pocket costs may end up being several hundred dollars a month.
That's why it is such good news that the Institute of Medicine, a non-partisan advisory panel within the National Academy of Sciences, recommended this month that every health insurer be required to cover contraceptives, free of charge, as part of women's preventive care. If the recommendation is accepted by the U.S. Department of Health and Human Services next month, it would put an end to cost barriers that keep far too many women -- including large numbers of Latinas -- from being able to afford birth control.
At Planned Parenthood Mar Monte we have seen a marked increase in the demand for contraceptives among our clients as the recession has taken a huge toll in jobs and health insurance -- especially in our Central Valley service area, one of the hardest-hit regions. When people are struggling just to pay the rent and utility bills, it's not surprising that they would decide this is not a good time to add to the family. But how can someone who has been laid off and lost their health coverage afford a monthly bill for contraceptives that might be the size of a car payment?
Californians are fortunate to have the state Family Planning, Access Care and Treatment (FPACT) program that allows PPMM to provide free or low-cost contraceptives to low-income patients. But many people, such as my neighbor, don't realize they have access to FPACT, and many women who have insurance coverage through their jobs still must make steep co-payments for birth control.
It's no wonder that almost half of all pregnancies in this country are unintended, according to the Guttmacher Institute. By making contraceptives available to everyone, we will reduce the rate of abortions and the number of life-threatening pregnancy complications -- which are more likely among mothers with unintended pregnancies because they often don't seek adequate prenatal care.
Then there are the cost benefits. Clearly, medical procedures as a result of unintended pregnancies are far more expensive than the price of birth control. In fact, when federal employees received full coverage for contraceptives more than 10 years ago there was no increase in cost.
For far too long, women's contraceptives have been treated by insurers as though they were a luxury -- a luxury that's out of reach for women in some communities. The message behind the IOM recommendations is that contraceptives must be treated as an essential part of good preventive health care. I'm sure my neighbors would agree that it's high time.
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