National Consumers League

Cutting costs for contraceptives: Saving money and staying healthy under the ACA


A recent study shows that since the Affordable Care Act (ACA) mandate for insurance plans to cover contraceptives, we’ve seen a large reduction in out-of-pocket spending. In 2013, women saved $1.4 billion! This is important for all American women because too many skip preventive care and other health services due to cost. It appears that free contraception is having a large effect on the rate of pregnancies and abortions in the U.S. But some women are still paying out-of-pocket.

The ACA has strengthened women's access to many different types of preventive care—including mammograms and all prescribed FDA-approved contraceptive services and supplies—without cost-sharing. However, as a Kaiser Family Foundation study found, not all plans are covering the cost of contraceptive services for consumers, despite the federal mandate to do so. The president of the American Congress of Obstetricians and Gynecologists, Dr. Mark S. DeFrancesco, stated, “Too often, medical management is used by some insurers as a barrier to access for patients.” The Department of Health and Human Services issued guidance for health insurers to clarify the ACA provision on contraceptive coverage without cost-sharing. With these clarifications, we can hope for full coverage of contraceptives without co-pays. 

U.S. Senator Kelly Ayotte (R-NH) has introduced the Allowing Greater Access to Safe and Effective Contraception Act to make birth control pills and other contraceptives available over-the-counter for people aged 18 and older. While the bill would make contraceptives easier to obtain, it may not keep these services free of cost-sharing. Insurance companies only cover contraceptive services that come with a doctor’s prescription. Dr. Mark S. DeFrancesco said, “Instead of improving access, this bill would actually make more women have to pay for their birth control, and for some women, the cost would be prohibitive...we cannot support a plan that creates one route to access at the expense of another, more helpful route.” The Allowing Greater Access to Safe and Effective Contraception Act also repeals parts of the ACA. Studies continually demonstrate improved health among the U.S. population due to the ACA. The Act is doing its job.

The age restriction that Senator Ayotte’s bill puts on over-the-counter birth control would also limit the population that benefits from access to contraceptive services. Medical experts should make these decisions about contraceptives, not politicians! While getting a prescription is a burden for many, the cost that comes with over-the-counter medication creates barriers for people who can’t afford it. Advocates say birth control and other contraceptives must be made both accessible and affordable to all those who are looking to access these services. The benefits of making contraceptives easy to access and inexpensive are clear and even favorable to conservative politicians: fewer unwanted pregnancies and abortions, and more women having the ability to make decisions about their health.