Before a 2012 contraceptive mandate, 30 to 44 percent of women’s medical spending used to go toward birth control. After the mandate, those numbers fell to 13 to 22 percent.
- After the birth-control mandate went into effect, women whose employer-provided health insurance fully covered birth control were slightly more likely to get any prescription contraceptive. They were also more likely to choose more expensive, long-acting methods, such as implants, intrauterine devices, and sterilization. One study has found people using such methods are 20 times less likely to have an unwanted pregnancy compared to people on birth-control pills, patches, and vaginal rings.
- The contraceptive mandate also helped women take birth-control pills more regularly. (When taken perfectly, pills are more than 99 percent effective.) One study of insurance claims found that co-pays as low as $6 increased the likelihood that women would stop filling their generic pill prescriptions.
IT MIGHT HAVE PREVENTED ABORTIONS
- There’s evidence that free birth control prevents pregnancies, births, and abortions among teenagers. Before the passage of the contraceptive mandate, scientists ran a study offering zero-cost contraceptives to more than 9,000 girls and women, ages 14 to 45, in the St. Louis area. Thirty-four out of every 1,000 teens who participated in the study became pregnant, and 10 out of every 1,000 had an abortion. The national teen pregnancy rate at that time was 159 per 1,000. The teen abortion rate was 42 per 1,000.
Unplanned pregnancies are a significant problem in the United States. According to a 2012 Brookings Institution report, more than 90 percent of abortions occur due to unintended pregnancy.
Each year, about 50 percent of all pregnancies that occur in the US are not planned, a number far higher than is reported in other developed countries. About half of these pregnancies result from women not using contraception and the other half from incorrect or irregular use.
A new study by investigators at Washington University reports that providing birth control to women at no cost substantially reduces unplanned pregnancies and cuts abortion rates by a range of 62 to 78 percent compared to the national rate.
.. From 2008 to 2010, annual abortion rates among study participants ranged from 4.4 to 7.5 per 1,000 women. This is a substantial drop (ranging from 62 to 78 percent) compared to the national rate of 19.6 abortions per 1,000 women in 2008, the latest year for which figures are available.
The lower abortion rates among Choice study participants also is considerably less than the rates in St. Louis city and county, which ranged from 13.4 to 17 per 1,000 women for the same years.
Among girls ages 15 to 19 who had access to free birth control provided in the study, the annual birth rate was 6.3 per 1,000, far below the U.S. rate of 34.3 per 1,000 for girls the same age.
.. While birth control pills are the most commonly used reversible contraceptive in the United States, their effectiveness hinges on women remembering to take a pill every day and having easy access to refills.
In contrast, IUDs and implants are inserted by health-care providers and are effective for 5 to 10 years and 3 years, respectively. Despite their superior effectiveness over short-term methods, only a small percentage of U.S. women using contraception choose these methods. Many can’t afford the cost of IUDs and implants, which can cost more than $800 and may not be covered by insurance.
PROVIDING FREE BIRTH CONTROL DOES REDUCE ABORTION RATES
Colorado provides a real-life experiment on whether providing safe, effective, long-acting birth control can reduce unwanted pregnancies and abortions. The state’s Department of Public Health and Environment got private funding in 2008 for a program to provide long-acting reversible contraceptives (LARCs), such as IUDs and hormone implants, to low-income women for little or no cost.
“The Colorado Family Planning Initiative helped cut the abortion rate nearly in half for women aged 15-19 and by 18 percent for women aged 20-24,” the department said in a 2017 report. “Between 2009 and 2014, birth and abortion rates both declined by nearly 50 percent among teens aged 15-19 and by 20 percent among young women aged 20-24.”