If you're one of the tens of millions of women who currently have access to no-cost contraception thanks to the Affordable Care Act, you're hopefully paying close attention to what's happening in Washington. Senate Republicans moved quickly in an overnight vote Wednesday to begin paving the way for a repeal of President Barack Obama's health care reform law, commonly known as Obamacare. In dismantling the Affordable Care Act, an estimated 30 million people could potentially lose their health insurance, while millions more see their coverage drastically change. But how will an Obamacare repeal affect contraception coverage?
In approving a budget resolution during an overnight voting spree on Wednesday, Senate Republicans opened the door to begin the process of repealing multiple aspects of the Affordable Care Act. While Republicans have vowed to "repeal and replace" Obama's health care reform law, they've so far offered few details on what or how they propose replacing Obamacare. With no firm plan for replacement, many women are concerned an Obamacare repeal will have a negative impact on their reproductive health.
As most women who were using birth control prior to when the Affordable Care Act went into place will know, the stuff isn't cheap. For women, one of the biggest benefits of the Affordable Care Act has been access to no-cost birth control. In 2012, the Affordable Care Act defined birth control as a preventive care service, which required health insurance plans to cover it with no patient co-pay, effectively saving women a lot of money. In 2013 alone, the contraception mandate saved women more than $1.4 billion in out-of-pocket expenses, Reuters reported a study from the University of Pennsylvania showed.
The mandate is widely popular, according to a 2015 survey from the Washington Post and the Kaiser Family Foundation, which found 77 percent of women and 64 percent of men supported the Affordable Care Act's contraception mandate. However, despite it's popularity, the fate of no-cost contraception coverage is looking pretty grim.
While Republican Congress members might decide to keep certain aspects of the Affordable Care Act, conservative lawmakers have talked repeatedly about doing away with the law's contraception mandate. In arguing the Affordable Care Act was "trampling on religious freedom" at the 2012 Conservative Political Action Conference, Rep. Tom Price of Georgia, Trump's pick to head the Health and Human Services Department, dismissed the idea that Obamacare's contraception mandate provided women with much needed access to birth control. He claimed there was not one woman who couldn't afford to cover the cost of her own birth control. "Bring me one woman who has been left behind. Bring me one. There's not one," Price said.
The truth is, Republicans don't need to repeal Obamacare in full to deny women access to no-cost contraception. Rather, they need only to remove birth control from the list of preventative services providers are required to cover without co-pay.
In light of repeated threats of repeal, some states have sought ways to preserve the access to free contraception. California, Vermont, Illinois, and Maryland moved to enact the ACA's contraception mandate into state law in 2014. Now, with Trump pushing Congress to immediately repeal Obamacare, New York, Minnesota, Colorado, and Massachusetts are looking to pursue similar measures to ensure contraception is fully covered by health insurance providers.
While there's not much good news about how a repeal of the ACA will affect women's reproductive health, women will likely have some time to plan and prepare should Republicans and President-elect Trump follow through with promises to immediately repeal Obamacare. According to some health policy experts, it's likely that changes to the no-cost contraception mandate will not come into effect until annual insurance plans come to an end on Dec. 31, 2017.