Remember way back last week when the Washington Post reported on the leaked recordings of the GOP meeting about the ACA repeal? (That seems like forever ago, I know…) Among other worries, the Senators fretted about the political fallout for defunding Planned Parenthood. As we previously discussed, that’s because PP provides amazing services, the vast minority of which are abortions though many of us have gotten their contraception from them (me included — they were great!).

Despite this hand-wringing, more recent reports by Rewire suggest that the House Budget Chair says that the mandate to provide birth control at no cost is not part of their current program and PP defunding is still on the table. Currently, the ACA holds that birth control is preventative care (i.e., preventing a birth!) and does not permit insurers from charging a co-pay.

Yet more damning is the contention by HHS nominee (yes, still a nominee) Tom Price that “not one woman” has ever struggled to pay for birth control. I really hate categorical statements like this. How could that ever be true? I’m also a social scientist so I go to the data.

So I started searching for an indication of just how much contraception costs and how much women have saved. I first came across this article in Health Affairs that used data from a national insurer to estimate the savings for women. They estimated for an IUD and the pill and estimates were consistent — women saved an average of $250/year. Two things. First, according to the Guttmacher Institute, 27% “of all U.S. women who receive contraceptive services—and 44% of all poor women—receive that care from a publicly funded family planning clinic.” (Planned Parenthood was responsible for more than one-third of those women’s visits.) That means that $250/year might not feel like a lot, but to women already struggling to make ends meet, these are not easy financial choices to make.

gender_pay_gapSecond, consider recent estimates by the Institute for Women’s Policy Research suggesting that women still face a pay gap of just under 80% for full time work (consider, however, that women make up a disproportionate share of part time work…). So, for a job where a man earns $50K, a comparable woman earns $40K. (Oh, and by the way, the pay gap is worse if you’re in any of the following categories a mother, nearly any other ethnicity or race other than white, disabled, or not straight.) Pretty cool. So, we make less plus we have to pay so we don’t have a kid. That sounds fair.

Next, I wanted to know what the actual consequences on unwanted births of the ACA birth control mandate. Is it decreasing abortions? I mean, Republicans REALLY hate abortions. So, maybe the birth control mandate helped with that. You must think they would like that. And guess what — research suggests it did! Research published in the New England Journal of Medicine found a statistically significant and clinically meaningful reduction in the number of repeat abortions. Among a group of identified at-risk women and adolescents, providing free contraception reduced abortion rates to half of the national average.

Now, I’m a social scientist and feel obliged to point out potential issues with generalizability so I will mention that this was NOT a study of the ACA but was instead a study of the provision of free contraception among at-risk women. However, an additional study from Oregon suggests similar cost savings and reductions in abortions in Oregon. And the Guttmacher Institute’s seminal 2015 study stated that women’s access to contraceptive care just from publicly funded family planning clinics “allow[ed] women to plan the timing of wanted pregnancies and to avoid unintended pregnancies—they helped women to avoid some 1.3 million unintended pregnancies in 2014 alone.”

The results speak for themselves. The ACA provides a mandate for birth control coverage. That leads to cost savings among women. And there are fewer abortions. Win. Win. Win.

David Brat
“Women are up in my grill!”

Now, back to those pesky Republicans. They are nervous. As documented in leaked tapes, representatives running from meetings with constituents, and attestations of women being “up in their grill,” there is a good chance we can save the birth control provision of the ACA and even keep Planned Parenthood funding.


So now what?

Now, we work. In an interview yesterday with Fox News, Trump even admitted that the repeal and replace may not occur until next year. Time is a good thing, but we need to keep up the pressure.  Because this is something that the House and Senate are handling simultaneously, today we suggest making calls this week to your three MOCs (yes, I know, but still will probably only take 5 minutes!) about saving the birth control provision.

Here’s a script:

“Hi, my name is [name], and I live in [town]. Representative Diane Black suggested this week that Republicans are not planning to keep the birth control provision of the Affordable Care Act as part of the repeal plan. Like more than half of Americans, I don’t want to see this provision removed. Where does Representative/Senator [name] stand on this issue?”

If against repealing: “That’s wonderful to hear. Thank you taking my call!”

If in support of repealing: “I am disappointed to hear this. I would like a written response from the Congressman/woman/Senator about how s/he plans to address the increased health costs women will face, especially low-income women. My address is as follows . . . Thank you for taking my call!”

If undecided: “I hope that the Congressman/woman/Senator understands that the majority of Americans do not want this provision repealed, and that if it is repealed, it would mean a significant increase in health care costs for women, particularly low-income women. I would like a written response about how the Congressman/woman/Senator plans to address this. My address is as follows . . . Thank you for taking my call!”

Looking for to spend another #fiveminutes on this? Find out when your members are holding town halls or constituent meetings, write letters to the editor or op-eds to your local news outlets, and donate to Planned Parenthood. You could also try a skilled social media take down like this too.

Photo credit: Steve Helber