Birth control is covered under the Affordable Care Act
Many women express concern on social media
"My talking with patients has completely changed," one doctor says
Some women are on the hunt for reversible birth control that could last through a Donald Trump presidency.
Tweets and Facebook posts about getting intrauterine devices, or IUDs, swept social media Wednesday as women warned each other that their access to birth control might dwindle once the President-elect takes office next year.
Throughout his campaign, Trump has promised to repeal the Affordable Care Act, or Obamacare, which mandates that insurers in the health insurance marketplace provide coverage for all FDA-approved birth control methods, including IUDs, with no copayment or coinsurance when provided in-network.
Repealing the act is also a “high item on the list” for Trump’s Republican colleagues, Senate Majority Leader Mitch McConnell said Wednesday. However, for now, enrollment will still be available through January 31.
Neither Trump nor Congress has revealed a detailed plan of what would replace the ACA, so no one knows exactly what would happen to birth control access.
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In September, Trump said that he actually is not in favor of requiring a prescription to purchase birth control.
The American College of Obstetricians and Gynecologists expressed a similar position in 2012 when it indicated in a “committee opinion” that oral contraceptives should be available over the counter. The opinion was reaffirmed this year.
However, growing concern that access will be thrown out under a Trump administration has changed the conversations that Dr. Anne Davis, an OB/GYN in New York, has with her patients – and the questions that they bring to her.
Shaken with worry, many women have had tears in their eyes this week as they waited in her office, said Davis, who also serves as consulting medical director for Physicians for Reproductive Health, a nonprofit that says it works to improve access to comprehensive reproductive health care, including contraception and abortion.
“Between last week and this week, my talking with patients has completely changed,” Davis said. “Last week, it was all about, ‘Let’s talk about what’s best for you,’ and it was all about the patient. This week, politics is in the chair next to me.”
Davis said she overheard her medical secretaries responding to an influx of IUD-related questions from patients on the phone Wednesday.
“They said, ‘That’s the third one we’ve had this morning who called saying “I need to get my IUD as soon as possible, because I’m really worried I’m going to lose my coverage,” ’ ” Davis said.
An IUD is a small T-shaped plastic device that is inserted in the uterus by a doctor to prevent unwanted pregnancies. The device can be easily removed by a doctor.
The types of IUDs that are available in the United States include ParaGard, Mirena and Skyla. Once in place, ParaGard IUDs are effective for 10 years or more; Mirena can last for at least five years and Skyla for three years.
In 2015, the Food and Drug Administration approved Liletta for use, which can prevent pregnancy for up to three years. Then, in September, Kyleena was approved and it can prevent pregnancy for up to five years (PDF).
“Since the election, we have seen an uptick in questions about access to health care, birth control, and the Affordable Care Act. While we truly hope that birth control methods will be available, accessible, and affordable to all women under the Trump administration, we understand people’s real concerns about losing access to birth control, which is basic health care for women,” said Dr. Raegan McDonald-Mosley, chief medical officer at Planned Parenthood Federation of America, in a written statement to CNN.
“We have seen an increase in IUDs over the last few years thanks to the Affordable Care Act and growing public awareness of their safety and efficacy, and we expect that trend to continue. Planned Parenthood health centers nationally have seen the total number of patients using IUDs increase 91% over the last five years,” the statement said.
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Virtually all sexually active women of reproductive age – about 99% – have used at least one contraceptive method in their lifetimes from 2006 to 2010, according to a 2013 National Health Statistics Report from the Department of Health and Human Services (PDF).
About 7% of sexually active women use IUDs, according to a 2015 data brief from the National Center for Health Statistics (PDF).
As women wait to see what will happen in the future of their birth control options, what advice does Davis have?
“You have to talk to somebody to figure out what’s the best birth control plan for you based on your circumstances, and if you want to get a method that is long-lasting, like IUDs, those do have a big upfront cost, so get it while it’s covered,” she said.