National Partnership for Women & Families

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From the desk of ... Debra L. Ness, Repro Health Watch

In Science v. Politics, Science Scores a Win

July 21, 2011 | Health Care | Reproductive Health

A milestone for women's health is finally within reach: On Tuesday, the Institute of Medicine (IOM) identified the full range of FDA-approved contraception and birth control options as preventive health services - and recommended that they be made available to women without additional fees or co-payment under health care reform. IOM's decision, which was based on strong scientific evidence, finally confirms what most women already know: that birth control is basic preventive care.

Preventive care is at the heart of the Affordable Care Act, so IOM's recommendation is an encouraging step toward realizing the promise of health care reform for women. For most women of reproductive age, contraception and birth control are the care they need most, the care they get most regularly, and their main reason for interacting with health providers and thereby receiving other kinds of health care they need. Timely access to contraceptive services vastly improves maternal and child health, and it has been the driving force in reducing rates of unintended pregnancy in this country.

On average, women spend at least 30 years being sexually active but trying to avoid pregnancy. But with 30 years of fertility comes 30 years of expensive contraception - and studies show that even minimal co-pays deter individuals from obtaining the care they need. [1] In fact, one study found that low-income Americans reduced their use of effective health care by 44 percent when required to make co-pays. [2] In 2008, 36 million women -- more than half of women of reproductive age -- needed contraceptive services and supplies. [3] Of that group, 17.4 million needed publicly funded contraception. [4] For these women, eliminating expensive co-pays is the key to ensuring they have access to the care they need. So IOM's recommendation is vital to the health of millions of individual women -- and of our country as a whole.

At long last, it's time to put politics aside. These science-based recommendations must guide policy, and politics should not intrude. Secretary Sebelius should move quickly to make these recommendations policy under the Affordable Care Act, so women are able to access the contraceptive services they truly need. It's about time.


[1] Solanki G and Schauffler HH, Cost-sharing and the utilization of clinical preventive services, Am J Prev Medicine 17, no.2 (Aug 1999) 127-133.
[2] Ku L, Charging the Poor More for Health Care: Cost-Sharing in Medicaid, Washington, DC: Center on Budget and Policy Priorities, 2003.
[3] Frost JJ, Henshaw SK and Sonfield A, Contraceptive needs and services: national and state data, 2008 update, New York: Guttmacher Institute, 2010.
[4] Frost JJ, Henshaw SK and Sonfield A, Contraceptive needs and services: national and state data, 2008 update, New York: Guttmacher Institute, 2010.


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