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One (more) reason why birth control mandates matter

Posted by Ryan Morgan on November 05, 2013 at 11:41 AM
One of my favorite things about my job is hearing women's stories about how reproductive health policies affect their lives.  As you might imagine, these stories are a far cry from the hyperbolic, politicized stories you hear from extremists who, for example, complain that it's "not fair" that birth control is covered under Obamacare.  Their rationales range from "we're paying women to have sex"

to mistakenly thinking contraceptives are "abortion-causing drugs."

Enough. Let me share with you a story a Tell Them advocate shared with me about the impact of the birth control mandate in her and her daughter's lives:

I’m a state employee, on the main Blue Cross Blue Shield State Health Plan. They have long covered birth control for an employee or spouse, but not for a dependent unless there is medical necessity. This has not changed with the ACA rules on birth control going into effect—they say they are grandfathered and project changing their rules in 2015. My college-student daughter has been getting the pill with a $9 copay on the basis of medical necessity (heavy periods). But now she wants to change to the Mirena IUD. I think this is a very good idea; I got a Mirena IUD after menopause for treatment of endometrial hyperplasia, and I love it. When I got mine, the State Health Plan paid about half the cost. They did that by putting it in the same category as injectable specialty drugs. But now I am told that they do not cover the Mirena at all under any circumstances, even for medical necessity. I spoke to Blue Cross Blue Shield, Express Scripts, and the South Carolina Public Employee Benefit Authority. It makes me so angry that they take away choice when over the 5 years it is less expensive than the pill. My daughter will probably get her Mirena in January at Planned Parenthood of Massachusetts, which offers it at about a $300 discount compared to all the options I have looked at in South Carolina. The price to buy Mirena direct from the company is $843. Our gynecologist charges about $130 for insertion. Planned Parenthood of Massachusetts charges $670 including insertion, I assume because they get a large quantity discount. I called Planned Parenthood and put in my upstate South Carolina zip code, and the call went to Planned Parenthood of Ashville. They quoted $722 for the device plus the cost of three appointments (an initial appointment, then insertion, then a check). My daughter has been in a monogamous relationship for several years, so the Mirena is appropriate for her as birth control as well as being wonderful for controlling heavy periods. I actually used a diaphragm for birth control all my reproductive life, but I wish I had known about the Mirena when my periods got heavier and heavier in perimenopause. I toughed it out but when I had bleeding after menopause that needed to be treated I discovered Mirena as a much lower hormone treatment than taking progesterone by mouth. I had a couple of hours of cramps after insertion and a few days of spotting. Since then it has been trouble free and I have had no further bleeding. What's your story?  Why do you think birth control should be covered under Obamacare?

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