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President Trump’s contraception rule ignores the reality that birth control is health care

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The birth control pill had a revolutionary impact on our nation when the FDA approved it for use more than 50 years ago. It gave women the opportunity to plan their family in a medically-safe way, which studies have linked to lower infant mortality and abortion rates. It also provided treatment for conditions like endometriosis and polycystic ovary syndrome. Despite this clear and essential medical need, birth control pills were rarely treated like an important medication. Insurers often treated it like a luxury instead of basic health care, failing to cover it in insurance plans and leaving women to pay exorbitant out-of-pocket costs that sometimes totaled as much as 44 percent of their health care expenses.

This all changed when President Obama signed the Affordable Care Act (ACA) into law. More than ten years after Viagra was first covered by insurance, insurers were finally required to cover birth control at no cost. This policy recommendation was made after an Institute of Medicine committee of 16 leading women’s health care experts embarked on a rigorous eight month process. I brought the ACA to the floor of the House as chairwoman of the House Committee on Rules, and it remains one of my proudest moments. The results have been striking.

{mosads}As a result, 62 million women now access contraception at no cost to them, which has helped drive down total prescription drug costs for all Americans by 63 percent nationwide. One study estimated that women saved more than $1.4 billion on birth control pills alone in just a single year. This is money that women are now free to spend on food, education, other medical or household expenses, or to improve the quality of life for her family and children.

The impacts go beyond just savings. With women free to plan for their future, the rate of unintended pregnancy is at a 30-year low, teen pregnancy is at an all-time low, and women are better able to avoid high-risk medical conditions like pre-eclampsia. In fact, the Guttmacher Institute found in January that the rate of abortions in the United States has fallen to its lowest level since the Supreme Court issued its landmark Roe v. Wade decision protecting a woman’s Constitutional right to choose in 1973.

Unfortunately, the Trump administration moved late last week to roll back this progress. This move would let anyone, from bosses to insurance executives, decide who gets access to contraception coverage. It’s not just employees that will be impacted, students attending a private college or university could also see the health care coverage they rely on ripped away.

Women won’t just have to pay slightly higher costs under this rule, they will have to pay for the full cost of their birth control if it is no longer covered. That’s no small thing. Birth control pills can cost more than $600 a year without insurance coverage, with some brand name and low estrogen pills costing much more. Longer-term methods like IUDs could cost up to $1,000 without insurance, with the up-front costs totaling the average month’s salary for a woman earning minimum wage. Meaning that women may make their health care decisions based on cost, not what is best for them. 

Turning back the clock on contraception also means going back to the days when many women couldn’t decide if or when to start or grow their family. It means forcing women to choose between paying for their birth control or paying for their groceries. And it almost certainly will mean higher abortion rates and more unplanned pregnancies.

Watching Congressional Republicans as the president has announced this rule, I am reminded of what my former colleague, Rep. Barney Frank (D-Mass.), once said. Speaking at Ford Hall back in 1981, he said, “The Moral Majority supports legislators who oppose abortions but also oppose child nutrition and day care. From their perspective, life begins at conception and ends at birth.” 

His words are just as true now as they were then. That’s because the Republicans supporting President Trump’s new rule were unable to extend the Children’s Health Insurance Program before it expired on Sept. 30. More than 9 million children get their health insurance through this program. The Republican majority also routinely cuts funding for food stamps and other nutrition programs. Just last week, the House considered a budget resolution that cut funding for Medicaid, education, and housing, inevitably hurting children. Their hypocrisy is striking. Truly caring about children means caring for them long after they are born.

This is not a controversial issue, an estimated 77 percent of women and 64 percent of men support providing contraception care at no cost. It is outrageous that the president has moved unilaterally to take our country backwards, and far from what Congress intended with the Affordable Care Act. The Washington Post recently found that President Trump said more than 20 times since his campaign began that he respects women. There is not enough evidence to convict him of that. He should put his words into action by realizing that respecting women means trusting them to protect their health and safety and to plan their families.

Slaughter represents New York’s 25th District and is co-chair of the Pro-Choice Caucus.


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