Men Can't Get Contraception Under Obamacare

The Affordable Care Act isn't just screwing things up for ladies in the birth control department — Obamacare doesn't cover men's contraception like vasectomies and condoms even though the law requires most private health plans to offer the full range of contraception methods and services free of cost to consumers. But, the act only specifies preventive services for women, which leaves out methods men might traditionally buy. The Guttmacher Policy Review has released new analysis with solutions that would help men get access to contraception under the Affordable Care Act.

However shocking this might be to some, contraception for men is pretty damn important and widely used. According to the analysis, roughly 25 percent of female contraception users rely on methods used by their partners — male condoms or vasectomies — as their most effective means of preventing an unplanned pregnancy. Not only are condoms and vasectomies considerably less costly than some forms of female contraception — for example, female sterilization is more expensive than a vasectomy — both are also less invasive than most female birth control surgical procedures and have fewer dangerous risks associated with them.

This turns out to be pretty bad for couples, according to Adam Sonfield, the lead author of the analysis. Sonfield told Bustle in a phone interview that it's important for couples to be able to access whatever contraception they need at different points in their lives because relationships are always evolving.

By favoring female sterilization over male sterilization in terms of cost sharing, you're putting your finger on a scale that could affect a couple's decision making. It's being pushed up towards the cheaper method even though the cheaper method might not be what's best for them. It's not good for the couple and it's not good for the insurance company either. You don't want people choosing a method that's more invasive and more expensive when it's just as effective as another method.
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Sonfield said the average woman uses four or more types of contraception methods over the course of her life. Those changes usually result from the normal changes of life — age, having children, convenience, etc. He said that making it harder for couples to access certain kinds of contraception could affect how correctly they use the method, which might cause more unplanned pregnancies.

Women who can get the method that they want are more likely to use it correctly, and, therefore, prevent an unplanned pregnancy. Interfering with that choice of method can interfere with your choice or ability to use that method correctly.

So, interfering with what contraception is offered free of cost affects couples, families, and insurance companies (the latter have to pay for maternity care if an unplanned pregnancy results). But, separately, couples aren't the only ones who sometimes want access to condoms. Young people and teenagers often turn to condoms because you can buy them anywhere and you don't need a doctor's prescription. But, if they were provided for free as part of insurance plans, there would be fewer barriers standing between teens that could prevent them from using them at all or using them correctly.

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Apart from the fact that states are indirectly affecting couples family-planning decisions, Sonfield said language excluding male contraception is also a problem because "it perpetuates the all-too-common view that contraception is solely the woman’s responsibility." Sonfield said that many couples want equal control over their contraception decisions, but the Affordable Care Act, in its current form, is preventing that. He offered a few solutions in the analysis.

  • First, Congress "could enact legislation that explicitly includes the full range of contraceptive methods — male or female — under the preventive services provision."
  • Second, President Barack Obama's administration "could adopt a different interpretation of the ACA provision and define methods used by men as preventive care for women."
  • Third, reproductive health advocates could potentially convince health plans to act on vasectomy by educating them about the costs in comparison to female sterilization, "by influencing negotiations between plans and large employers and unions," or through public pressure.
  • Fourth, states could pass their own legislation to clarify the ACA provision.
  • And, fifth — the most promising solution — is that the U.S. Preventive Services Task Force could recommend that male contraception be covered. Under the ACA, any positive recommendation from the USPSTF is automatically incorporated into the preventive services requirement, after a one-year grace period, according to the analysis.

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