A funny thing happened in Colorado when the state decided to start handing out free birth control in 2008: the rate of unintended pregnancies and abortions dropped radically among teens and young adults. The indisputable success of Colorado's "birth control for you, and you, and you..." program is instructive for health policy in the rest of the country. It's time for free birth control now, for everyone, everywhere — because free birth control programs benefit not only the people using the birth control, but their communities and the country at large. Let IUDs rain from the skies and onto communities large and small, America.
Colorado's program lasted for six years, giving us all a long look at what happens when you start providing free long-lasting birth control to teens and young adults. Using private funding, the program offered training to clinics along with supplies, and the results were clear: According to a study published in October 2014, unintended pregnancies dropped in the state by 40 percent from 2009-2013, and abortion fell by 42 percent over the same period. Perhaps unsurprisingly, when bridge funding to keep it going came up for a vote in May, Colorado Republicans succeeded in shooting it down, leaving the program in peril.
The program saved the state millions in public health coverage for unintended pregnancies, further proving the well-known fact that preventative care is cost-effective and sensible health policy. As the pilot program illustrated, providing free birth control is a highly effective tactic for addressing accidental pregnancy, and it's a model that could, and should, be extended to the rest of the country.
Free birth control is a particularly fraught issue in the United States, thanks to consistent moral panic about the consequences of handing out contraception without making people jump through unnecessary hoops and the fear that access to birth control will cause the country to turn into a cesspool of promiscuous degenerates.
This assumption flies in the fact of the facts, of course: Studies on sexual education demonstrate that well-informed teens often choose to have sex later than teens who don't receive comprehensive sexual education. The same holds true for birth control — a 2014 study showed that teens with access to free birth control tend to have fewer partners and to engage in sexual activity less frequently than teens without access. These kinds of studies torpedo the pearl-clutching claims of those who have a problem with earlier sexual activity, multiple partners, or frequent sex — because they show that giving teens the knowledge and ability to protect their sexual health doesn't specifically encourage any of those options.
Colorado's program is not the first to show that free birth control can make a positive impact in the lives of young people — free school condom distribution programs in cities like New York and Chicago have previously suggested that having direct access to birth control helps reduce unintended pregnancy rates. But the Colorado program provides the most comprehensive evidence yet that specifically providing free long-term birth control is a net gain for young adults and their communities.
And the program impacted more than just unintended pregnancy rates. In Colorado, researchers noted that young women, especially in low-income areas, experienced positive outcomes using birth control that helped them put off pregnancy while they pursued college and professional training. In their cases, free birth control actually served as an extremely effective method for fighting poverty, making even more of a case for extending this program nationally. When an unplanned pregnancy interrupts education, it deprives people of critically needed opportunities to rise out of poverty — so a country-wide free birth control program would provide huge benefits not only to women and girls, but to society in general.
There's a demonstrable cost savings for the government in preventing unwanted pregnancies, too, as it reduces the burden on government care and insurance providers to cover the costs of pregnancy and abortions. Colorado's Department of Public Health and Environment reported that every dollar invested in the free birth control program ultimately saved the state $5.85 in medical coverage. In fact, even some Republican politicians recognize the financial benefits of this program. Republican state Rep. Don Coram told NPR: "If you’re anti-abortion and also a fiscal conservative, I think this is a win-win situation for you."
For a national free birth control program to be successful, of course, it needs to be accessible to all, including those who may already have insurance. Contrary to what many think, not all insurance programs provide free birth control — people covered by plans that were "grandfathered" or purchased before the Affordable Care Act went into effect still have to pay for their birth control out of pocket, and many plans place limits on the brands or methods of birth control that are covered. Moreover, teens eligible for medical care through their parents' insurance might prefer to seek reproductive services confidentially if they come from conservative or controlling families. Any free birth control plan should cover these needs, as well.
When it comes to helping young adults take control of their sexual lives, sex education reform and access to family planning are clearly tightly interrelated — but pushing through a free birth control initiative may be easier than passing sex education legislation. Getting education reform of any nature off the ground can be challenging, especially when it involves charged social issues. But public health policy reform is often more straightforward — and getting a national free birth control program in place could set the stage for national sex ed reform. While pregnancy prevention is only one aspect of comprehensive sexual education, it's an important issue to tackle, and backing into it via a public health measure may be a sustainable approach.
With national health care reform in the public eye and on the Congressional agenda, this is a mandate we need to push through to protect teens as we also talk about sexual education and teen sexual health. Let it rain free birth control, because the results will be huge for American youth.
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