What the Latest Changes to the ACA Mean for Birth Control Access

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Women's reproductive rights always seem to be at the forefront in the back and forth debate over healthcare. Earlier this month, the Trump administration eliminated a mandate in the Affordable Care Act (ACA) that required employers to cover contraceptives through their health insurance plans. Also earlier this month, the House of Representatives passed legislation that made abortions after 20 weeks of pregnancy illegal. So far, there have been two failed attempts in replacing the Affordable Care Act (ACA), with more attempts presumably underway.

For women across the country, the replacement of ACA means their affordable access to healthcare is in jeopardy—birth control, cancer and STD screenings, and sex education make up the vast majority of the organization's services. And even if you don't get your birth control through Planned Parenthood, note that any form of bill that replaces ACA passes, it may no longer be free.

Women in particular must worry whether the daily reproductive choices we make for ourselves are at risk. And it's not melodramatic: The administration has promised a number of things that could completely alter our access to birth control, affordable reproductive care and screenings, and the very ability to take sole ownership over our bodies.

How it will all play out is anyone's guess, but let's be clear that the odds don't look any better than they did immediately after the election. Get mad, but get proactive too. Here's what you need to know.

What Is Currently Covered by the Affordable Care Act?

To understand the mass effect of an ACA repeal, we have to know what it actually covers. According to Erica Sackin, Director of Political Communications at Planned Parenthood, more than 62 million women have access to birth control and preventive care because of it. 

Birth control is free—even for those insured under private companies. Repealing Obamacare (as it's widely known) would, in effect, force women to pay out-of-pocket for their birth control again.

"Reproductive care involves birth control, cancer screenings, well-women exams and STD testing. Healthcare reform has been incredibly helpful for patients in bundling coverage for all patients’ medical needs. From OB care, hospital coverage, well-women exams, and birth control, the majority of group insurance plans include these benefits," says women's health expert and author of She-ology Dr. Sherry A. Ross.

While clinics like Planned Parenthood would theoretically offer low-cost options, that's a worry too—the upcoming administration is adamant about defunding the organization, which could spell uncertainty.

Does it matter if an employer covers birth control or not? 

According to Sackin, ACA made it a guarantee that women still received birth control coverage through their health insurance plan, regardless of religious affiliation or beliefs that employer may have. Even if the employer objected and chose not to include birth control coverage, ACA made it so that women would could get it in other ways. With that mandate now gone, so does that security. 

"There is no longer a safety net that makes sure women get coverage no matter what," she says. "You're now completely at the mercy of your boss."

What are the cons to banning abortions at the 20-week mark of pregnancy?

While abortions past the 20th week of pregnancy are rare, they happen for complicated circumstances. "A bill like puts a woman in the impossible situation of needing to access an abortion for medically important reasons, either for her health or because there is a complication with her pregnancy, and being unable to do so; it puts women's health at risk. At the end of the day, politicians are not the people who should be making the medical decisions for a woman. It should be a woman in conjunction with her doctor and her family," says Sackin. 

Should we be thinking about getting an IUD now? 

Women everywhere agree and are putting out the call.

Here's why: An IUD, or intrauterine device, is a more permanent version of birth control—after it's implanted in your uterus (in a very simple in-office procedure), it offers a steady stream of birth control hormones for several years. There's also a nonhormonal version called the Paragard, or copper, which can last up to 10 to 12 years—enough to well outlast an eight-year presidential term. Should you wish to get pregnant, your IUD can be removed at any time.

That's why women everywhere are heeding the call to get one now while it's covered by insurance so that they don't have to worry about paying for or having access to birth control at all during a Trump presidency.

Weigh your options with your doctor, and note that when choosing an IUD, it can be helpful to learn from other women's experiences. (We have a few personal IUD accounts.) Even if you're not sure that an IUD is your best course of action, let this movement inspire you to make a game plan of your own. 

Don't want an IUD? Here's what else you can do.

For starters, you may want to begin researching how much different methods of birth control cost when they're not under the umbrella of the Affordable Care Act so you can make the most informed decision for your budget and lifestyle. Planned Parenthood's website is a great resource for this: Its birth control hub features an exhaustive list of options, detailing maximum potential cost, effectiveness, directions for use, and pros and cons for each method. If you'd rather opt for the pill, you can use sites like GoodRx and WeRx to locate the cheapest prescriptions in your area.

Also remember that if you're in a relationship and don't need to take hormonal birth control for health reasons, this doesn't have to be just your burden. While we're still waiting for that male birth control injection to be cleared, there are countless other options for your partner to consider. On that note—above all else—remember that you're not alone. Chances are that women in your personal circle and broader community are just as scared and uncertain as you are. Worse yet, they might not even realize what's at stake. Talk it out, spread the word, and let's work through this together. 

If you don't have an ob-gyn, you can get low-cost access to birth control (including an IUD) at your local Planned Parenthood. Visit the organization's free app to find a location near you.

What can you do to protect your reproductive rights? 

Yesterday, Planned Parenthood launched its "Fight for Birth Control" campaign to make sure women don't lose access to birth control because of eliminated mandate. "It helps people across the country who believes in women's rights to take action and protect access to birth control and make sure that people across the country don't lose access to this important health care," says Sackin. "We started with a call on businesses themselves to not only move to protect birth control coverage for their employees but also take a public stance and make clear that they will stand up for birth control as a business for birth control, and also make clear that they support these women who work for them, and they support women's access to basic health care and rights."  She notes that Kodak and Universal Records are just two of the big corporations who have publicly announced that they will provide female employees access to contraceptives through their respective insurance plans. 

Along with the campaign, Planned Parenthood created a web hub that lists all the business in support of its initiative and is a great resource for women who may need help talking with their employers about the possibility of losing coverage. "This is really designed to help people advocate within their own work spaces and work with
their employers to both make sure that their birth control isn't going to be dropped and also to help
encourage their companies to take a public stance. 

"Funding for women’s reproductive rights is a bi-partisanship issue that must be protected, it’s a matter of life and death," says Ross. "The best way to fight for your reproductive rights is to call your local government representatives and let them know your outrage about this potential threat to women’s health care. Participate in marches and rallies with groups that feel the same outrage."

You can easily find out who your representative is and how to reach them by going online. You can also donate to Planned Parenthood and look into joining organizations that help protect women's reproductive rights (or rights in general) to make a difference. 

Next up, read up on ovulation symptoms