Skip to main content

Sign up for our newsletter.

Quality journalism. Progressive values. Direct to your inbox.

This #GivingTuesday, whatever is your first priority, your second priority has to be independent media.

2021 has been one of the most dangerous and difficult years for independent journalism that we’ve ever seen. Our democracy is facing serial existential threats including the climate emergency, vaccine apartheid amid deadly pandemic, a global crisis for biodiversity, reproductive freedoms under assault, rising authoritarianism worldwide, and corporate-funded corruption of democracy that run beneath all of this. Giving Tuesday is a critical opportunity to make sure our journalism remains funded so that we can stay focused on all your priority issues. Please contribute today to keep Common Dreams alive and growing.

Please Help This #GivingTuesday -- Though our content is free to all, less than 1% of our readers give. We’re counting on you. Please help Common Dreams end the year strong.

The current House Republican health care proposal would jeopardize women’s access to essential preventive health services, including family planning. (Photo: Getty)

Why Birth Control Is Essential for Americans’ Health

 It is 2020. The American Health Care Act has become law, and the Department of Health and Human Services (HHS) has eliminated contraception from its list of essential preventive services that must be covered by insurance without cost sharing.

Let’s imagine a woman named Margaret. She is 25 years old and has Type 1 diabetes requiring insulin. She has high-deductible health insurance through her job with a construction company. For the past 2 years, high out-of-pocket medical and prescription costs have led Margaret to avoid doctor’s visits, and her sugar levels are too high.

Margaret and her fiance want to delay having children for a few years until they become more financially stable. Additionally, Margaret’s doctor recommended that she delay pregnancy until her sugar levels are better controlled, to improve outcomes for both Margaret and a baby. However, because insurance companies are no longer required to fully cover contraception, her insurance charges a $100 copayment for an intrauterine device (IUD), the most effective reversible birth control method and a particularly safe option for most women with chronic medical conditions.

Unable to afford the copay, Margaret and her fiance use condoms. But — as happens to 20 percent of women using condoms for birth control over the course of a year — Margaret unexpectedly becomes pregnant. She delays initiating prenatal care due to the cost. Because of this delay and her high blood sugar levels, her pregnancy is complicated. She delivers her baby pre-term and he requires a neonatal ICU stay, which presents further emotional and financial challenges to her family.

Repeal of the Affordable Care Act’s no-cost coverage of contraception will make stories like Margaret’s all too common and will have harmful consequences for both babies and women — especially the growing number of women who already live with chronic disease.

A sexually active woman of reproductive age has an 85 percent chance of getting pregnant in a year without birth control. Since contraception was included in the HHS’s list of essential preventive services for women in 2012, most private insurers now must provide comprehensive contraceptive coverage without charging patients copays or deductibles. HHS estimates that since passage of the ACA, 55.6 million women now have access to contraception without copays. Although early research has not yet shown dramatic changes in contraceptive use post-ACA, in previous studies, eliminating contraceptive copays has increased women’s use of the most effective methods, and reduced rates of unintended pregnancies and abortions.

Unintended pregnancies are associated with risks to woman and babies, including higher likelihood of delayed prenatal care and premature delivery. However, reduced access to contraception is particularly devastating for women managing chronic diseases like diabetes, high blood pressure, heart disease, and obesity. These conditions make pregnancy riskier and have contributed to the rise in maternal deaths in the United States seen in the last two decades. Some of the risks can be reduced by careful planning of pregnancy, including preventing conception until a woman is ready. Thus, enhanced access to birth control, along with maternity care and other women’s health services under the ACA, has potential to help reverse that disturbing trend.

The current House Republican health care proposal would jeopardize women’s access to essential preventive health services, including family planning, through reducing Medicaid coverage and benefits and by blocking federal reimbursements to Planned Parenthood. Further, the current requirement for no-cost coverage of contraception could be removed at HHS’s discretion. These changes would be catastrophic for millions of women, and especially those who battle medical conditions already.

As primary care physicians at Massachusetts’ largest birthing center, we see cases like Margaret’s every day. The researchers, doctors, and public health experts who drafted the ACA’s women’s health provisions understood that contraception is essential to the long-term health of women and families. However, amid political and religious outrage over required coverage of contraception, lawmakers and activists often overlook the fact that planning pregnancy can save lives.

As Congress considers repeal of the ACA, patients and doctors must advocate for no-cost contraceptive coverage. Massachusetts has an opportunity to lead other states, with the Legislature’s proposal of An Act Advancing Contraceptive Coverage and Economic Security in our State (ACCESS), which would mandate contraceptive coverage without copays for Massachusetts women with any health insurance. No-cost coverage works, and should be a component of any nation’s commitment to its citizens’ health.

Lydia Pace is Faculty Director of the Women’s Health Policy and Advocacy Program, Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital. Eve Rittenberg is Primary Care Medical Director, Gretchen S. and Edward A. Fish Center for Women’s Health, BWH. The opinions expressed here are solely their own and do not reflect the views and opinions of Brigham and Women’s Hospital.


© 2021 Boston Globe

Lydia Pace

Lydia Pace is Faculty Director of the Women’s Health Policy and Advocacy Program, Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital.

Eve Rittenberg

Eve Rittenberg is Primary Care Medical Director, Gretchen S. and Edward A. Fish Center for Women’s Health, BWH.

... We've had enough. The 1% own and operate the corporate media. They are doing everything they can to defend the status quo, squash dissent and protect the wealthy and the powerful. The Common Dreams media model is different. We cover the news that matters to the 99%. Our mission? To inform. To inspire. To ignite change for the common good. How? Nonprofit. Independent. Reader-supported. Free to read. Free to republish. Free to share. With no advertising. No paywalls. No selling of your data. Thousands of small donations fund our newsroom and allow us to continue publishing. Can you chip in? We can't do it without you. Thank you.

Omar Hangs Up After Boebert Uses Call to Double Down on 'Outright Bigotry and Hate'

"Instead of apologizing for her Islamophobic comments and fabricated lies, Rep. Boebert refused to publicly acknowledge her hurtful and dangerous comments."

Jessica Corbett ·


Win for Alabama Workers as NLRB Orders New Union Vote After Amazon's Alleged Misconduct

A union leader said the decision confirmed that "Amazon's intimidation and interference prevented workers from having a fair say in whether they wanted a union in their workplace."

Jessica Corbett ·


'For the Sake of Peace,' Anti-War Groups Demand Biden Return to Nuclear Deal With Iran

"It's time to put differences aside and return to the Iran nuclear deal," said one advocate.

Julia Conley ·


'That's for Them to Decide': UK Secretary Rebuked for Claiming Vaccine Patent Waiver Won't Be 'Helpful' to Global Poor

One U.K. lawmaker asked when the government would "start putting the need to end this pandemic in front of the financial interests of Big Pharma?"

Andrea Germanos ·


Shell Slammed for Plan to Blast South African Coastline for Oil and Gas During Whale Season

"We cannot allow climate criminals, like Shell, to plunder in the name of greed," said Greenpeace.

Kenny Stancil ·

Support our work.

We are independent, non-profit, advertising-free and 100% reader supported.

Subscribe to our newsletter.

Quality journalism. Progressive values.
Direct to your inbox.

Subscribe to our Newsletter.


Common Dreams, Inc. Founded 1997. Registered 501(c3) Non-Profit | Privacy Policy
Common Dreams Logo