B]efore the ACA I was forced to pay over $40 per month for my birth control, even with insurance. After the ACA my birth control cost was $0! No burden, no cost and no excuses!
I had to choose between healthy food and the birth control that helped manage my extremely painful period.
I paid out of pocket for an implant while studying abroad, because it was more affordable than paying out of pocket back home.
I'm a provider at a Title X-funded clinic and I have a patient who had to drive three hours to reach the clinic—the closest one with her method of choice in stock—in order to get an IUD before her insurance expired.
My pharmacist frequently has to argue with my insurance company about how soon I can pick up my next pack of pills, since I skip the placebo week to avoid painful periods.
AZ: Last year I started my journey to finding long-term, effective contraception. I had no support or help from my anti-sex-before-marriage family to help me learn about birth control, but I did have the Internet, and my research pointed me in the direction of the Nexplanon implant. After talking to my insurance numerous times and not getting any detailed information, I took the plunge, banking on either the ACA to help me or scraping the money together somehow, and thankfully I was completely covered- one hundred percent. I loved the implant, but upon the election of Trump I, like many women, became terrified that access to affordable contraception would go away. My pay puts me barely above the poverty line and I knew that contraception without coverage would set me back badly in the future. The implant lasts for three years, and I had already used up a year, so I decided to get the Mirena IUD, as it is good for five years. I was nervous this time, because the costs would involve removal of the implant, insertion of the IUD, and the IUD itself. But again, thanks to the ACA, my balance was $0.00. I would be willing to shell out almost anything if it meant not getting pregnant, but many women do not have that luxury. The ACA is not perfect, but it has helped me and so many others. I will mourn the day that we go back in time by repealing this life-saving law.—Sarah, 22
Auburn, AL: Thanks to the ACA, I was able to find a birth control method that worked for me. When a couple versions of the pill didn't work, I wanted to try the Mirena IUD. I had heard horror stories of it being $1000 or more, something I definitely could not afford. But thankfully my health insurance covered it completely. My Mirena needs to be replaced in 2018, at which time I'll want to get a new one. If the ACA is repealed, I guess I'll have to start saving now!—Christina C., 29
La Puente, CA: What birth control means for me is that it allows me to have a period regularly. Before when I didn't take birth control I didn't have my period for almost a whole year and experience hot flashes at random. Now that I take birth control it allows me to have a periods regularly and I don't have hot flashes anymore. It makes my life a lot easier and made me realise that it's not just for sex, but there are other benefits of birth control which help a lot of people in many different ways. —Erica K., 18-25
Fresno, CA: I had lost my teaching position last year due to a clerical error on the end of my university. While I struggled in a demanding position as a long term substitute, I only brought home $800 a month, if I was lucky. I also was living with my boyfriend, and definitely didn't want children. Because of the ACA, I was able to gain access to birth control—the pill and later the NuvaRing. While financially, things have evened out, having access to birth control at no cost has made life easier. There isn't shame, I don't have to stress when emergency surgery has taken any income making birth control unaffordable, and I know that I am able to plan my family. —Kirs O., 27
San Diego, CA: I have been on birth control for about 10 years. When I was younger, my parents did not have insurance so I relied on local community health centers, planned parenthood, and even the University of California, San Diego's student health center for birth control. Getting pregnant at a young age and even now is not in my plans, and being on birth control was and continues to be my way of taking control of my health, my body and my future. I am eternally grateful for these health centers as well as the Family PACT program that was able to supply otherwise costly birth control for free because of my income.
When I first got enrolled into employee-sponsored insurance back in 2013, I no longer had to worry about overpassing the income bracket to get affordable birth control, my insurance covered gynecological visits and the birth control of my choice. If ACA is repealed, not only will millions of once uninsured/now insured and healthy Americans be left without options to treat chronic conditions or even afford to get sick, millions of young men and women will be faced with "pre-existing conditions" will be left without many options for their futures. In years past, an unplanned pregnancy was considered a pre-existing condition, let's not go back to those times. I understand our current house did not agree with the implementation of ACA in the first place, but I beg that they leave is with something better, don't take it away completely.—Romina B.A., 29
San Diego, CA: I used to get menstrual cycles so painful that I often had to miss school several days each month when I got my period. Because of affordable hormonal birth control pills, I was able to regulate my painful periods, clear up my acne, and continue going to school without missing days out of my cycle due to crippling pain.—Rose R., 21
San Francisco, CA: During graduate school I quit my job to focus on my studies. I had paid taxes for 12 years up until then, holding a well-paying professional job. And while I was able to access birth control through basic reproductive health insurance at my educational institution, my other relatively basic health care needs could not be covered under larger providers. Why? Because the ACA had not yet passed and pre-existing conditions could still exclude individuals from coverage.
Years prior I had had a LEEP procedure to remove HPV lesions from my cervix to prevent cancer. Yet, due to the greed of insurance agencies who were unregulated at the time, I was unable to get independent coverage. For a year, I couldn't qualify. Thank goodness for the ACA that eventually kicked in so that I could both succeed in a laborious graduate program, and care for my health. My story is an example of of those "in the middle"—in unique situations that policies do not only account for. People who are underpaid, or underemployed, yet not quite resource constrained "enough" to fall under the FPL. No one should have to choose between health and education. No one should be excluded from new health care because they previously took initiative and cared for their health—despite if that resulted in a diagnosis or not. Without the implementation of the ACA I would have continued to be hung out to dry—being punished for a condition I couldn't control.—Jennifer., 35
San Francisco, CA: I was able to get free birth control pills all throughout college thanks to the Affordable Care Act. Without access to my birth control, I may have become pregnant and would not be in a successful career today. The ACA enabled me to make appropriate family planning decisions and good choices for my future. I still rely on my birth control to maintain control over my body and my future. —Bailey T., 23
Ventura Country, CA: When I was in my early 20's and still on my parent's insurance, I was paying $25/month for the contraceptive pill. I take it for Polycystic Ovary Syndrome, and it is the only thing that regulates my hormones and keeps adult acne at bay. I moved to the UK from 2008-2015, where my prescription ended up being free under the National Health Service. Once I returned to the USA, I was able to get free contraceptive pills for a few months from Planned Parenthood while I searched for work and waited for my insurance to kick in at my new job. Now, through my work insurance plan, my contraceptive pills are $10 for a three month supply! A massive change from the pre-ACA insurance plans! The ACA has made a massive difference in my ability to afford contraception! —Kim S., 32
Salida, CO: Being a family planning and reproductive health provider has provided me with many opportunities to see the incredible strength and perseverance of the human spirit.
I was privileged to to have a young woman come into see me for LARC. As it turns out, contraception was just a small portion of this person's story. This young lady had been through multiple trials and tribulations in her short life. She suffered the loss of a parent at a very young age, the remaining parent unfortunately was abusive and as a result my patient was put into foster care. Her experience in foster care also let her down when she subjected to the sexual misconduct of the foster parent. This led the teen to run away to live an independent life at the ripe age of 16. This patient showed extreme strength and courage for a young person of her age. She went on to work full time to afford an apartment alone while attempting to finish high school . Her dreams were to graduate high school and then to pursue a military career. For this reason she was seeking out LARC. She was making all attempts to better her life.
I was struck by how this young lady had overcome many obstacles and had unwavering mission to have a better future. The previous 16 years did not do her any favors. Again contraception was a very small portion of this patient's plan. I was privileged to provide contraception to this incredibly strong and persevering young woman. I let her know how impressed I was with her drive and encouraged her to continue to follow her dreams. She continues to be a role model to me. The power of planning one's life empower me every day to do what I do. —Karen A.
Bear, DE: I am an Advanced Practice Nurse specializing in reproductive health. I work at an FQHC where the majority of my patients are uninsured or ACA covered. I have three stories.
- A 36 year old mother of four was pregnant again. She was diabetic, hypertensive, uninsured and living on very little money. Her husband worked 60 hours a week to feed her and the children and another child was going to be overwhelming. She continued the pregnancy but knew she did not want to ever become pregnant again. Even at the discounted rate of $360, she could not afford to have a tubal ligation after her delivery and she was terrified that she could become pregnant again, something that would be very dangerous for her and financially impossible. Thanks to Title X, we were able to give this woman a 10 year copper IUD free of charge. She and her family were extremely grateful.
- I had a 17 year old patient who became pregnant but miscarried. She wanted to prevent pregnancy because she aspired to go to college and become a nurse. She was on her parents insurance and knew they would never allow her to start a method. They felt that birth control lead to pre-marital sex. She was able to get Nexplanon implant free and confidential under Title X.
- I had a 25 year old mother of two whose partner was abusive. She slept in her children's room at night but he still would come in and drag her away from them to rape her in the other room. She had no family, friends or resources to help her out of this situation but still wanted to try to escape. She knew getting away from her partner would be impossible if he managed to impregnate her again. He meticulously checked the money she spent, contents of her purse and even her menstrual cycle. She was able to convince him to take her to our office by saying she was having pelvic pain. Once in the exam room, she told me her story and we were able to place a copper IUD that same day and billed under Title X so the partner would not get the bill and ask questions.
These are only three of the hundreds of stories I could tell you about lives changed, even saved, by this program. —Emily R.
District of Columbia
Washington, DC: I began using hormonal contraceptives at age 15. I was experiencing painful, lengthy periods; my doctor diagnosed me with dysmenorrhea and prescribe the birth control pill to regulate my cycle. At the time I was under my parent's insurance plan, which classified dysmenorrhea and a "preexisting condition" which affected the coverage of my birth control pill. I was lucky because I had parents who I could talk to about birth control and who could afford to pay for my prescription - but others are not so lucky. Shortly after I began the pill, the ACA was enacted and my birth control cost was now $0.00! It was a huge relief to not have to worry about the cost in the event I had to pick up the prescription myself. Now I am an adult with my own health insurance. I am again very lucky; I have insurance through my employer, a women's healthcare organization, who understands the value of contraceptive coverage. Without the financial barrier, I have been able to explore new birth control options, such as the implant, to effectively prevent pregnancy and regulate my periods. The ACA removes the cost barrier for birth control for those who otherwise wouldn't have a choice.—Rhiannon R., 29
Washington, DC: I first started taking the pill when I was probably around 16 or 17. I wasn't sexually active, but I have endometriosis and my cycle is seriously unbearable. The pill helped some, but the pain still remained. Throughout my many moves, college, multiple doctors, and other health issues, I've had to switch pills and found that some were not as effective, some didn't work at all, and some doctors wouldn't even prescribe me the pill. I was outraged to think that a doctor wouldn't allow me access to a medicine that my body needed. In 2015, I became unemployed and was on Medicaid. I am *so grateful* that DC expanded their Medicaid coverage and that I was able to be covered so that I could be protected, be safe, and keep receiving my medications (which I needed for birth control, as well as other health conditions). However in 2016, once again I ran into an issue with a doctor who wouldn't prescribe me the pill; I mean, this is 2016 right?! I did my research, and thanks to a local clinic I was able to receive an IUD; bonus, I didn't have to pay anything! I will tell you that although having the IUD inserted isn't exactly the most fun I've had (let's just say it's not a day at the amusement park lol), I love not having my cycle, dealing with cramps, and bonus, my chronic migraines have reduced. I truly feel thankful to Obama and the ACA for allowing women's health to be a priority. Without that coverage, I would still be suffering from doctor to doctor, uncertain about my protection, dealing with horrendous cycles and horrible migraines.—Shanelle O., 29
Washington, DC: I started birth control at 13 to help regulate painful, long, and irregular periods. I went through many brands of pills, the shots, the ring and struggled to find a birth control type that worked for me. At 22 I was finally diagnosed with endometriosis and my doctor recommended I get a copper IUD after trying virtually every other method of birth control. Thanks to the ACA, my IUD it was inserted at no cost to me. As a poor graduate student I wouldn't have been able to afford my IUD without the ACA keeping me under my parent's insurance and ensuring that insurance companies cover birth control. My symptoms affected my ability to work and go to school, so being able to manage my reproductive health means everything for my future.—Bree R, 26
Washington, DC: I was diagnosed with PCOS about 4 years ago and prescribed birth control to control my hormone levels so that I can have a higher chance of fertility later in life if I ever wanted to have a child. As a law student, I am restricted from working full time and am under a lot of loans. The ACA has allowed me to take birth control without a charge, which has been a big relief to me. Many may not know, but birth control is not only used as a contraceptive. It can be used medically for conditions such as mine.—Sophia C.,25
Washington, DC: I used to pay at least $30 a month for my birth control. Thanks to ACA, it is now covered! I am so grateful for the ACA making my contraceptive care affordable and stress-free. —Christina P., 26
Washington, DC: Back in high school, before I was on birth control, my period was brutal. I was the kind of goody-two-shoes girl who would take DayQuil and go to school with the flu just so I wouldn't miss class, but I wanted to skip school when I was on my period. My periods were extremely heavy and extremely painful (my thighs would feel like they were going numb from how much my body hurt). I went on birth control when I was 17 and now my periods are manageable and predictable. When I had my first job out of college, the cost of a pill pack (around $37) was more than the cost of a week of groceries for me, and I wasn't making enough money to choose both. Thanks to the ACA, however, my birth control pills didn't even have a co-pay and I was able to continue eating healthy foods every week. —Ponta A., 25
Atlanta, GA: When I was 16, I was started on birth control since I was taking Accutane, which is contraindicated for pregnancy. I had to be on BC in order to take the medication. It also helped with my near-debilitating cramps and extreme bleeding. Over the next decade, due to insurance and switching gynocologists, my birth control was switched well over ten times. I’d find one that worked and then insurance would no longer cover it. At the worst, I was paying a $75 copay each month in order to get the prescription that worked the best for me. That’s a lot of money as a college student. Since the ACA, my BC has remained consistent, my copay is $0 and I no longer have to hassle with prior authorizations and co-pay assistance cards.
I’m still hopeful that one day we can do a year supply for BC. It is challenging to continue to argue with the pharmacy who argues with the insurance companies about when I can pick up my medication. Not taking the placebo pills each pill pack (ie not getting a horrible, bloody, crampy period each month) means mine runs out a little earlier than insurance “deems necessary.” They are not doctors and many of them likely have never had a period.
Folks should not have to get pregnant because insurance won’t authorize the medication. There is still red tape around accessing birth control. Many reproductive health centers are booked months out, as I had to wait three months to be seen in 2015. Gaps in care certainly still occur as well.
As a sexual health nurse, many of my clients are in similar situations. Waiting to see a prescribing provider or trying to navigate accessing the medication while not having insurance is quite challenging. Most of my clients aren’t eligible for Medicaid because we didn’t expand it in Georgia. They also can’t afford insurance through the ACA so they are stuck in the very large gap in coverage.
We cannot point fingers at folks that get pregnant unintentionally. It is proof that there is a systemic issue. Same with abortion; abortion is a symptom of a systemic problem. Insurance being run as a business rather than supporting folks when needed is still an issue. It was ludicrous to me that as a women’s healthcare provider myself, I was unable to access care and was fighting to get BC.
The ACA is not perfect, but it certainly helped me access care. There are certainly ways we can improve chunks of it, but seeing college students still under their parents’ insurance, accessing BC and other reproductive healthcare and seeing people free up the copays they used to be paying is certainly a step in the right direction. Repealing the ACA and starting from scratch would be a huge mistake. —Mary K., 29
Honolulu, HI: As a comprehensive reproductive health provider, the ACA has had a huge impact on my patients, especially adolescents and young adults. Younger women are now able to control their reproductive lives and pursue the careers and the futures that are important to them. They are able to afford highly-effective long-acting methods that previously would not have been possible. —Shandhini R.
South Bend, IN: As a 15 year old, virgin I might add, I was first given the pill because I had cramping so horrible I would miss 1-3 days of school a month. Birth control helped me continue my straight-As and education without significant interruption.
In my twenties I worked in the food and beverage industry and went years without insurance. I was denied coverage in my thirties when I finally had money to afford it because I took Wellbutrin for a short bout of seasonal depression. I was unable to get affordable birth control for many years, often opting to forego hormonal bc if I was in a relationship. I didn't want children yet so we used less proven methods of prevention and I was, thankfully, lucky.
In 2014 I was able to enroll in our state market through ACA. I received a Pap smear and my regular check up for the first time in almost 8 years. I was able to get birth control again and choose the best one for my body. In 2015, I got married and am now, today, 34 weeks pregnant, by choice! My pregnancy has been covered and I haven't been in fear of losing our home or livelihood to have our baby, until now. We only want one child, so I'm hoping that I will still have coverage and options after birth to make the best choices for our family and future. I shouldn't have to decide whether to buy diapers or birth control. I'm in a loving, Hetero marriage, seemingly the ideal for the GOP, and should have the right to healthcare access for myself, husband and child. Our future matters and all Americans deserve dignity and healthcare. —Amy T., 35
Indianapolis, IN: I'm 26 and married but I'm not ready to have kids any time soon! When I got my IUD 2 years ago my husband and I made less than 50,000 combined and we could barely take care of ourselves. A baby would have devastated our financial future. Thanks to the ACA, I was able to get the Skyla IUD with only a $25 co-pay! I am so thankful that birth control is accessible and affordable. —Angel C., 26
Polk, IA: To be upfront, I am not a very sexually active individual. Even in my teenage years, I never really engaged in a lot of sexual activity (at least, not comparable to that of normal teens). Which, is why I never really practiced/used birth control until my early to mid 20's. Genetically, my reproductive system is predisposed to work in overtime...meaning, heavy, HEAVY periods, severe cramping, unpredictable cycles, etc. So, when I started experiencing cycles that lasted months at a time (at one point, 5 months straight of heavy menstruation), with only a minor break in between, I ended up becoming so anemic that my doctor recommended I use birth control pills as means to regulate my cycle/prevent further harm to my reproductive organs/. Granted, my lack of exposure/knowledge of the topic due to low sexual activity combined with a midwestern 'abstinence highly recommended/is the best form of contraception' education made me think 'huh?!'....but, after a couple of months taking birth control, my cycle became regular (like clockwork actually), I became healthy/strong....and I was able to function like a professional adult (i.e.—I was no longer tired due to the anemia/irritable/didn't have to stock up on boxes upon boxes of tampons, etc). Birth control is important to me for many reasons. First, as a working professional female, I know when I'll need to take into account my cycle into my schedule, and I won't have to worry about heavy menstruation/needing to bring an extra change of clothes just b/c I bleed heavier than the average person. Secondly, it affords me the ability to plan for my future/family, etc. AFFORDABLE birth control is even more important b/c as a recent law school graduate with ZERO income (at the moment) denying affordable access to means of preventative health cuts short my ability to maintain a healthy regime for reproductive care. Genetically, my mother, aunts (her sisters), and grandmother all experienced the same above symptoms—and all (or most) had to undergo hysterectomies by their mid to late 40's in order to prevent the affects of heavy bleeding/anemia. Which, in turn, threw their estrogen into orbit and caused other health problems. While this may or may not be in store for MY future (only time will tell), I do know that deviating from my current reproductive plan will increase this risk...and having to do so due to lack of access/affordability is rather unjust. For me, birth control is not just about sex...but rather a marvelous medical device to use as means to control and maintain a healthy reproductive lifestyle. I am thankful for it every day...and am grateful for those who fight for my right to continue to have access to such affordable care. —Alison S., 32
Bucksport, ME: Sterilization after second c section. Had issues with ovarian cysts bursting (very painful) was put on nuvaring no further issues. —Theresa, 38
Baltimore, MD: Prior to the ACA, I paid almost $1000 out of pocket for an IUD. I had been using the pill and the ring before that, but because of my erratic work schedule, it was prohibitively difficult to stay on track with birth control methods that I had to remember to use at a particular day or time. The IUD has been life-changing. Not only did it eliminate the opportunity to forget to take a pill or use a ring, I also got one of the most highly reliable methods of preventing pregnancy, so that I could wait to have a child when I had completed my medical training and felt more ready. I was tremendously fortunate to have had the resources to pay for the IUD essentially out-of-pocket, though it was a relative hardship at a time when I didn't have a lot of spare cash. For someone who has to choose between paying rent and getting an IUD, I can 100% understand why many people would choose essential expenses over contraception. Interestingly, after my daughter was born, I had a new IUD placed—at no additional out-of-pocket cost. Being able to choose the best method without concern for upfront cost is something that I want for all women. —Diane H., 38
Baltimore, MD: I have been using the pill for years now and I've always been happy with it, and that's what I plan to use until my husband and I are ready to start a family. Before the ACA, I was paying 50 dollars a month and that was a huge expense for me when I was a single girl right out of school. The first time the pharmacist told me I did not owe anything for it, it was a HUGE weight off my back. I knew I didn't want kids and I knew I needed birth control but 50 dollars a month was hard to swallow every month. Fifty dollars a month adds up really quickly. Not only was the cost ridiculous to me, the fact that I was instantly given the right, that day in the pharmacy the first month my birth control was free, to make my own reproductive decisions. That was a very palpable feeling for me. Fifty dollars a month was something I had to add in to my budget every month, but thanks to ACA, I didn't. My reproductive health did NOT have to be budgeted for and that was wonderful. No woman should have to add reproductive health into their budget. —Meredith F., 29
Gaithersburg, MD: I am currently studying abroad and was planning to get an implant when I returned to the United States this spring under the ACA. I am, however, very worried that Trump is going to take away free birth control through the ACA. So I got an implant inserted here and paid 260 Euro for it. I figure better safe than sorry, because without the birth control coverage in the ACA, it would cost me about $860 in Maryland to have one inserted. So I paid about 1/4 the cost here abroad. —Simone J., 19
La Plata, MD: I had my first pregnancy scare when I was seventeen, with my first boyfriend, and after my first sexual encounter. I was a star athlete and guaranteed to get an academic scholarship post high school. In going to the doctor, I was told no need to worry because you can't get pregnant anyway, you don't even ovulate. After hearing this my boyfriend and I were a bit relieved, but it was just the beginning of my problems. Fastforward to my freshman year of college, I missed at least two weeks of school consecutively due to severe anemia...my period would not end, for two weeks with a heavy flow. I thank God for my roommate who brought me food because I could not even get out of bed, my mom considered letting me take the semester off. I finally was able to see a doctor who had some experience with these symptoms, I was diagnosed with polycystic ovarian syndrome (PCOS). It took until 2015 to find something that worked for me, which ended up being the pill. I have been getting a three month supply of the pill for free and been able to graduate, start a career, and live freely. Just this week, I went to get my birth control and was told I can now only get a one month supply for $10. My costs have gone up exponentially and Trump isn't even in office yet. This is terrifying. No-cost access BC has significantly changed my life. Beyond pregnancy prevention, it has given me the ability to live. —Kiersten G., 22
Montgomery County, MD: I wanted to get a copper IUD for many reasons. My biggest impetus was getting a form of birth control that was non-hormonal but dependable and easy, especially because of my family history of breast cancer. The risks associated with the pill and its affect on my health gave me every reason to switch to an IUD, but it was too expensive. The ACA gave me access to the copper IUD, making it possible for me to switch to a form of birth control that lowered my risk for breast cancer, improved my overall health and was a more dependable form of birth control. —Jen U., 22
Salisbury, MD:I was on the pill most of my teenage years and into my early 20s because the option was the cheapest for me. As I learned more about my choices, I really wanted to get a more reliable form of contraception but I could not afford it with my co-pay. Specifically, I wanted the Mirena IUD. After the ACA went into effect, I set up an appointment with a nurse practitioner who counseled me about my choice and agreed to insert it. First, I needed to get authorization from my insurance and due to the mandate for 100% contraceptive coverage, I was approved to get the IUD at no out of pocket cost to me. The relief I felt was not only monetary but psychological. There was no stress, no hassle, no fighting with insurance companies, and most importantly no barriers that weren't identified by my care provider that I could not get this method of birth control. I had choice with a piece of mind. —Yuliya L., 26
Holyoke, MA: I am a registered nurse working in a teen parenting program. Our goals include supporting young parents to learn parenting skills, to continue to identify and work on their educational and employment goals, to support their children's and their own health and to set family planning goals. These goals are attainable when parents and their children have access to health care. Many young women and men recognize only after having their first child, how important being able to plan pregnancies is, related to their ability to complete educational and employment goals. Access to health care and family planning is vitally important not only to these children and families, but for the economic stability of the community. —Karen R.
Rice County, MN: I am a nurse practitioner in a primarily rural county with no dedicated sexual health or teen clinic services. Title X funding and the ACA mandate covering reproductive care has allowed me to offer safe, effective and long-acting birth control to young women who never knew they could access it. I strongly believe that giving women control over their reproduction provides a level of confidence that extends into all aspects of their life. Contraception makes for empowered, strong and successful women. —Emily C.
Pearl, MS: I started the pill at 17 and used it until I was 20. I had to change pills twice because of heavy bleeding. At 20, my doctor suggested trying the Nuvaring. Because of insurance covering my Nuvaring, I regularly saved close to $300 and didn't have to pay anything. Then issues arose about a year and a half with the Nuvaring. I was then able to switch to the patch. Again, something I did not have to pay for, so I saved a couple hundred dollars. Winter of 2016 I went to get an IUD to have long acting birth control. This time, I was able to save more than $1,000. Now I don't have to to get medicine every month, and I'll get 3 years without worrying about missing a pill. I have had an extremely positive experience with birth control from the Affordable Care Act. —Amy H., 22
Columbia, MO—Provider Perspective: I have been a Women's Health Care Provider for 37 yrs with 20 years in Family Planning (Title X) services. I have seen many women who cannot afford birth control without Uninsured Women's Health Insurance (Medicaid) and Title X funds based on a sliding scale. If we lose monies for birth control there will be a lot more unhealthy, unwanted pregnancies that can lead to abortions and children not wanted and born into poverty. I know as I have seen what happens. Please we need to continue to support health care and birth control for women. Many times we are the only healthcare providers for the low income. It would be a big disservice to do away with health care coverage. —Carol G.
St. Louis, MO: I work for a Catholic hospital. Before the ACA, I had to go through Planned Parenthood to get birth control because my employer refused to cover it on their insurance plan. Even with PP, it cost me about $50 per month. That's a lot of money, considering that I have insurance and a good job. If the ACA is repealed, a lot of my coworkers will be unable to afford birth control. —Emily K., 34
St Louis, MO—Provider Perspective: I work at a Title X health center. We only have one location, but we stock long-acting reversible contraception (LARC) methods and practice same-day insertions. New patients can get an appointment within three days of calling. Other local health centers refer their patients to us because of our LARC expertise and ability to see patients without insurance. Two patient stories stand out to me. We saw a young patient who recently had an abortion. She lived about 3 hours a away from St. Louis. After the procedure, she wanted to start a LARC method, but her insurance was set to terminate soon. The health center she planned to go to had to order her LARC method and it would not arrive before her insurance terminated. She called us, and we could get her in, use her insurance, and get her a LARC. She drove another three hours to us because we were her only option. Then, another patient was on hormone therapy and told by her doctor she should not get pregnant. When she went to a local health center to get a Paragard, she found out she was already pregnant. She terminated the pregnancy, and then learned her insurance plan would not cover the Paragard. The health center, not Title X, quoted her $1,500 for the method, insertion, etc. She called us, and thanks to our Title X funding, we could get her a Paragard for $650. She was thrilled. It gives me such a sense of pride to be able to explain to patients, thanks to Title X funds, my health center can help ease the financial barrier to effective contraception. There are countless other stories, but these two really touch my heart. These patients persisted and because of our Title X funding, they received excellent healthcare. —Loire B.
Manchester, NH—Provider Perspective: I am writing my birth control story based on the patients that I see as well as my own personal story. First, my own: My mother, who is a religious woman, brought me to the doctors when I was an adolescent to get on birth control, in her words "just in case". I will forever be thankful for that, as it helped my symptoms and health significantly as well as educated me that I can have control over my body. When I was in college I was not able to afford birth control & well-woman screenings—I was struggling to get my bills paid for every-day-life like food and rent, let alone co-pays and birth control. I was able to utilize Planned Parenthoods Services, and to pay what I could to ensure I was healthy, and to get the birth control I needed.
I now work in a federally qualified health center in NH, where many of our patients are insured by the Affordable Care Act. Taking this away from my patients would decrease their access to birth control and other well-woman services (screenings, pap smears, etc) that they need. I know for myself in college, If I had to decide between food that week or a copay to my providers to get birth control—food had to take priority. I know many of my clients are in a similar situation. Pay for food, childcare, gas (etc) or pay for birth control. The Affordable Care Act has taken those decisions away, and have helped many of my patients access the services not only that they require—THEY DESERVE!
I have written to my senators to ask for their support on keeping Planned Parenthood funded, and to vote to keep the Affordable Care Act in place. Families should not have to make these challenging decisions and they have a right to basic human needs such as health care. I will continue to advocate for them. I hope these stories will help senators/congress see that these services are SO needed for families. —Sarah B.
Cape May, NJ: Before the ACA I was unable to afford birth control and hadn't been on it since losing insurance at the age of 18. During that time I spent hundreds of dollars on Plan B during those 5 years (because I was nervous of accidents happening). I have never been happier to be able to go to my local doctor and get the affordable contraceptive. Without the ACA making my birth control easy to access I don't want to think of where I'd be. —Shannon A., 25
Albany, NY—Provider Perspective: I'm a physician, an OBGYN specifically. When I started training, options for women living without insurance or under-insured were very limited. If they could afford a birth control pill it was often one that gave them symptoms (head aches, moodiness, loss of libido,etc) that would lead to them stopping the pill and getting pregnant. The ACA came into practice while I was a resident. Immediately there was an increase in the use of not only LARCs, but also pills that were once too expensive. Suddenly adherence to many methods wasn't an issue because the barrier to care had been removed. Now that I'm in private practice, my patient population has changed. Many of my patients are in college or grad school. Contraception is still very important and the most common topic I discuss with my patients. There is a general fear that they will not have access in the coming year if the ACA is repealed. Many are looking to get an IUD or Nexplanon just to avoid some of these barriers for the next few years. I can't fight against the tide of how things may change in this country. But I implore our new law makers to realize that many people did benefit from the ACA. And remind everyone that an unintended pregnancy is much more expensive to insurance over one year than any form of contraception would be over that same year. If it's just dollars and cents then it should be that simple. Contraception saves money. Please do not repeal our access. —Dr. Elizabeth E.
Bronx, NY—Provider Perspective: I am a Women's Health and Adult Primary care NP working in the Bronx NYC. I had a college-age female patient come in to see me the other day requesting an IUD ASAP "before Trump starts office since we do not know what will happen to our access to birth control once he is in office." She wanted a method that would last her the duration of his term since she was that concerned about her potential decreased access to care and since she wasn't sure what health care coverage would look like in the coming months and years. I was able to counsel her, discuss all options and insert her IUD before she returned to college from her winter break. This experience really left an impression on me as a provider because at the time she wasn't even sexually active but was so concerned about 1. access to care and contraception and 2. wanting to maintain control over her life goals/prevent pregnancy reliably until she is ready that she made this appointment while home on winter break to get a contraceptive method to serve for the potential duration of a Trump presidency. Many of my patients do not speak to me directly about their political thoughts or feelings about the presidency but this young student was motivated and aware and worried. She made a timely decision for the betterment of her health and to focus on her life goals while she still had access to a comprehensive health plan that allowed her to get an incredibly reliable and effective form of contraception that suits her needs. —Annelle T.
Far Rockaway, NY: This story starts with my first period, when I was 11 years old. I remember vividly how painful it was, but I just blamed it on it being my first period and not knowing much about periods. Now, at the age of 16 the pain did not lessen— throughout middle school and high school it was constant hospital trips, missing school, and pain so terrible that I wouldn't eat for 2-3 days. The decision was made between my mother and I to go to the gynecologist to inquire about birth control for the pain. I explain to the doctor how my pain levels were and that's when I realized the pain I was experiencing was not normal. That's when I received my first prescription of birth control pills and my quality of life changed immediately. First month of using the birth control pills I didn't feel like a "zombie" anymore and I was able to do normal everyday things while I was on my period. Now here's the kicker, every 3 months my mom would have to pay almost $100 and eventually $200 for a 3 month supply of pills. Simply this was not realistic for an upcoming college student. So during my first year of college during fall break I decided to go to my gyno. and change my birth control plan and that's when I found out about the nuva ring which was also covered completely by my insurance. The nuva ring changed my life because it was easier and so much harder to forget (For changing it in and out purposes). To end this story, I've been on birth control for 5 years now and it has been amazing! I know how difficult it can be to live with painful periods and not knowing what to do when those cramps, but just crawl into a fetal position. I don't plan to change my birth control plan because when I turned 16 and went to the gyno. it was the best decision of my life and I hope for more success stories like this for more females! —Sheneca S., 20
New York, NY: Through the ACA, my birth control pills were 100% covered by my insurance. I am able to live my life with a more regular routine and with less worry. —Stephanie L., 24
New York, NY: Since the ACA was passed, I have gotten monthly packs of birth control pills at no cost. This has been extremely helpful to me for many reasons, the first being that I have been a student for five years, and an expensive monthly prescription would not be conducive to my budget. Though I plan to have a family someday, it is not part of my current plan, and thus having access to no cost birth control is imperative. Additionally, my pill has decreased the severity of my menstrual cycle, which has been extremely helpful to me on several counts. Not to mention the fact that I believe that access to no cost birth control is a basic right that all women should have. If it were a medication for men, we would not need to fight for it like this.—Joanna M., 23
Durham, NC: In 2014, I was making my annual visit to Planned Parenthood to renew my prescription for my birth control when I started talking to my consultant about what I wanted for my birth control. I wanted something I didn't have to think about everyday. I was very interested in an IUD or a vaginal ring. I had looked into the IUD before and couldn't afford $1,000 payment with my entry level salary. Thankfully my Planned Parenthood consultant called my insurance company that was now covering IUDs at 100% due the ACA. Three years later and I am still thankful for my free birth control. —Catherine C., 25
High Point, NC: I must say before the ACA I was forced to pay over $40 per month for my birth control with my health insurance at work, now imagine not having the $40 every month. After the ACA my birth control cost was $0! No burden, no cost and no excuses! Thanks ACA! —Bernice L., 41
Halifax, NC: I had long heavy periods since I was 9. By the time I was 15 it started to take a toll on my health.After taking with pediatrician she recommended birth control pills. They have changed my life. What was once 9 days of very heavy bleeding and lots of discomfort, is now 4 days of heavy-ish bleeding and mild discomfort. —Makayla J., 19
Columbus, OH: Without the ACA, I would not have been able to afford first my birth control pills and, most recently, my IUD. I need the hormones to deal with health problems, plus it has the added bonus of protection from pregnancy. Taking away the ACA and making the cost of birth control prohibitive for so many people is insane. It will not solve any problems. —Sarah L., 22
Columbus, OH: I have had employer-provided health insurance for the last 10 years, but the ACA took my copay for monthly birth control from $15/month to $0. I have paid nothing for my birth control pills since the ACA went into effect. In addition, the ACA has allowed several of my coworkers to get an IUD for simply the cost of a doctor's visit copay. This health insurance policy has helped women across this country, even those with employer-provided insurance! —Stephanie B., 31
Saint Clairsville, OH: Before the ACA, cost was a major concern when selecting a birth control method. Although I had insurance, the three tiers for prescription co-pays made generics much more affordable than brand name prescriptions. I took a generic birth control pill for years because my preferred method required a hefty co-pay. Since the HHS ruling on preventative health services, I've been able to choose the method that best fits my needs without being limited by out-of-pocket costs. Access to contraception needs to be expanded (cover vasectomies!), not rolled back. —Danielle N., 30
Philadelphia, PA: I tried so so many methods before finding the true love of my life, my IUD! My thrice monthly migraines disappeared when I had her inserted. Best decision of my life. #ThxBirthControl— Danielle H., 36
Larksville, PA: Before the ACA, I was taking the pill, which was costing me about $30 a month. That comes out to almost $400 every year! After the ACA, I was still getting charged for the pill and had to do some digging to find out that my insurance plan was only counting a handful of types as "free". The law didn't require all BC to be free, just at least one of each type. I took the list to my provider and she chose one that was very similar to what I was taking that would be free. I didn't want to switch, but it didn't make sense to keep spending so much money on something I needed for my health, as well as to prevent pregnancy. The switch wasn't too bad and saving money has been wonderful! I worry about losing that benefit if the ACA is repealed. My husband and I have bought a house and got a dog since the switch, and I don't have $400 to spare. We will have to spread our funds out even thinner to make things work if the ACA is repealed.—Jean H., 32
Spartanburg, SC: I struggled with getting birth control prior to college, and the passing of the ACA, due to lots of social stigma, and the fear that I would have crazy out of pocket costs for my birth control. After my freshman year of college, and hearing about how birth control was covered by the ACA, I went for it: I was going to get my IUD. The process of getting approved was easy, and before I knew it I had a LARC. A weight of worry was lifted off of my shoulders: my risks for cancer were down, and I was practically guaranteed no children for the next 5 years (now 7!). Now, a year and a half later, I have had no issues, lighter periods, and have a steady sexual partner with whom I don't have to concern pregnancy scares or extraneous contraceptives. —Victoria S., 20
Arlington, TX: Between my husband and I, we have a total of 5 daughters ranging in age from 22 to 30. They all attended college and after graduated all became employed with companies that did not offer health insurance. We have been so very fortunate that we were able to keep them in our family insurance plan until they were able to secure their own! We still have one daughter that is in our plan, as she is 22 and working for a small event planning company. If the Affordable Care Act is repealed, she is not sure what she is going to do in regards to her health insurance. As many young women her age, she needs preventive care, contraceptive care, and catastrophic health insurance. Please do not repeal Obamacare! —Josie T.D., 55
Dallas, TX: When I was in graduate school, I was living on a meager income from research and teaching assistantships, in addition to student loans. I had tried both the pill and Nuvaring and nothing ever worked well for me. At this point, I was not using any form of contraception and knew something had to change. I have a degree in public health, and most of my studies focused on sexual and reproductive health. All of my classmates were getting IUDs and were raving about them! Luckily, our university required us to have insurance, and it provided truly quality care. In 2014, I decided to take the plunge and get my own IUD. I knew that hormones did not jive with my system, so I opted for a Paragard. It only took one visit, and it was SO EASY! It just felt like a bad menstrual cramp, and I had a little pain and spotting for the remainder of the day. I LOVE LOVE LOVE my IUD, and I am protected from pregnancy well into my 30s. The best part is...it was 100% FREE! Reproductive healthcare IS primary healthcare, and everyone deserves access to the family planning method of their choice-either for free or at an affordable cost. I currently work in teen pregnancy prevention, and I truly LOVE family planning. It allows women, men, and families to shape their own futures. The ability to control one's fertility is a HUMAN RIGHT, and I will ALWAYS stand by contraceptive access. It is a win-win for everyone. —Courtney P., 28
Hidalgo, TX: I'm currently an undergraduate student working on a meager research salary that barely covers book costs for my education. Fortunately, with ACA I am able to stay under my parent's insurance until 26. Not only has this been a complete lifesaver, my family suffers from a long history of cancer in the family and because I have insurance I am able to enjoy all the preventative care and screenings to ensure I am unaffected. Without this insurance I am not sure what I would do! The university does offer health exams for free however the prescriptions can be costly and in some cases limited. I am forever grateful for having covered as this has come in handy so many times! —Marie F., 23
San Antonio, TX: I am 26 years old. I was surgically diagnosed with endometriosis at the age of 23 after my 1st laproscopsy. My doctor urged me to get on birth birth control right away in order to avoid scared tissue build up, which was causing me a lot of pain during and near to my period. The pain was so great that I would often call in sick to work. I was not able to walk during my cramps, had difficulty going to the rest room and extreme back pain that was not controled with pain medication. So I took my doctor's advice and started taking the pill. Mind you, I am not on the pill to avoid pregnancy, for that I have a coper IUD. I am on the pill because of my medical condition. So at the beginning of this year when I picked up my prepscription at CVS I was shocked when the pharmacist asked me for an updated insurance card or to pay $600 dollars out of pocket for 3 month prepscription that I needed! $600 dollars! I couldn't believe it. I still can't believe it. Thankfully, I have insurance through my employer but my thoughts immediately went to those with high deductibles, who might be without health insurance this year, to several couples and women I know that need it. Why are we as Americans so concerned with making this medication unaffordable? Why? How does it harm society as a whole? Why is getting viagra easier than getting access to birth control? It's time to put our feelings aside when making legislations and start adding some commen sense to the process. The fact of the matter is, it should be a women's choice and our legislation is making it harder for us to make the choice. —Laura Z., 26
Arlington, VA: I love birth control. Not only because I get to enjoy a healthy sexual lifestyle without worrying about pregnancy, but because it controls my cystic acne and debilitating cramps. Birth control also gave me the freedom to get a double Masters degree in Public Health and Social Work. As someone who works in the public health field, I understand just how important birth control is for prevention. As someone with a background in social work, I understand the dynamics of class, race and gender and how birth control provides equity for women in the United States.
My personal birth control story starts when I was 20. I started having casual sex and wanted to get protection from pregnancy. I was in college and I didn't want to get pregnant. I started out of the pill and it was terrible. My body had a very poor reaction to the pill I was taking and my hormones were out of flux. So I switched to a different pill. And then a different one. Eventually, I tried Depo-Provera but ended up having a two month long period. I then went back on the pill to control the long-term break-through bleeding caused by the Depo shot. Then, my doctor suggested I try Nuvaring. Using Nuvaring was like laying down in your bed after working for 24 hours straight —it was comfortable, it did not interfere with my moods and it corrected all the issues I was having with other forms of hormonal birth control. Nuvaring is the best birth control for me. None of the other forms of birth control have controlled my cramps, my acne or my moods as well as Nuvaring has. But, that's where the good news ends.
I had graduate school insurance coverage until I was 26. My parents were uninsured so I did not benefit from that portion of the Affordable Care Act. However, I did receive my birth control for free through my graduate student insurance until I graduated in December 2014. Starting in January 2015, I've had to battle with three separate insurance companies to receive my legally entitled birth control method of choice.
My first issue was with Kaiser Permanente. Kaiser denied my birth control request and charged me over $900 for 3 months of birth control. My plan was not grandfathered and my birth control method falls under 1 of the 19 forms of birth control that are required to be covered in full by the ACA under the contraceptive mandate. After many calls to the insurance company, I only paid $36 per month for the Nuvaring. Still blatantly illegal but more affordable. Several months later, insurance through my non-religious employer started (there was a waiting period). I worked for Prince George's County, Maryland. I tried requesting Nuvaring and once again, I was denied. The plan was ungrandfathered and had no religious exemptions. The representatives I spoke with on the phone even admitted that I was correct but still, I was charged for my birth control. I reported them to the National Women's Law Center. Finally, I chose to go back insurance through the Healthcare Exchange and I started insurance with CareFirst. They explicitly denied all coverage of Nuvaring with no explanation. My fight for my legally mandated birth control method has been long, stressful and much more difficult than it needs to be. Because of my background in public health, I know what is entitled to me through the Affordable Care Act because I've read the entire bill. I also know, personally, how important birth control is to me (not only for preventing pregnancies but so that my cramps don't restrict me to bed two days each month). It bothers me so much that congressional members are not listening to research, anecdotal evidence or logic and trying to remove the contraceptive mandate. I will continue to fight for my right to birth control. —Kimi N., 28
Everett, WA: I have been on BC pills since I was 17 due to severe acne. While I didn't need it for contraception at the time it provided me the confidence I needed to finish high school. Then when I became sexually active I didn't have to worry about possibly getting pregnant in the middle of my undergraduate degree. I recent got an IUD so that I could begin my career and fully devote my time and energy to caring for mothers and their newborns as a nurse. I plan to go back to school to become a midwife. All things I would never accomplish if I had other mouths to feed and additional worries plaguing me at home. Now, when I do choose to add another human being to this already populated world, I will have the education and financial means to ensure he or she is a productive member of society that is well cared for, loved, and wanted by his or her parents. —Taylor N., 25
Madison, WI: Before I came to college, my parents were responsible for picking up the cost of my birth control from the pharmacy since they would always go in with me to get it. However, as I slowly became financially independent from my parents when coming to college, I became responsible for paying for my birth control. Transitioning into college was hard enough and finding a way to support myself financially while also having time to study compromised my ability to afford anything except the basic necessities. For me this meant discontinuing my use of birth control because I could no longer afford to pay for it. Personally, I used birth control for its ability to effectively control my hormonal acne and subduing menstrual cramps. Therefore, its absence in my life resulted in self-esteem issues because my skin was so acne ridden and discomfort from the pain of menstrual cramps. This all turned around with the ACA. Because of the ACA, I have been able to have access to birth control at $0 which has helped me return to living a happy and comfortable lifestyle and allowed me to begin feeling more confident in my skin. The ACA isn't perfect, but that doesn't mean women's right should be compromised because of it. —Miranda, 22