What It Costs Us


U.S. waits for the Supreme Court to decide constitutionality of President Obama’s Patient Protection and Affordable Care Act; Susan Wysocki, President at iWoman’s Health, talks about the economics of health care and female contraception …

Earlier this year, President Obama’s administration announced that most health insurance plans must cover free contraceptives for women as part of the rollout of the Patient Protection and Affordable Care Act, but church groups could opt out. After an outcry from religious groups and conservatives who said more religiously-affiliated organizations should also be given an allowance, Obama said other religious universities, hospitals and charities could also choose not to cover contraception in their health care plans.

Related: Super Tuesday & The Birth Control Effect

Some states are searching for ways to block Obama’s new rule, or to otherwise allow more leeway for religious groups to halt coverage. Last week, for example, Arizona Gov. Jan Brewer signed a bill that gives religiously oriented employers the ability to halt contraception coverage for birth control purposes. These employers would still have to provide coverage for birth control used for other medical reasons; the bill also affects coverage for abortion-inducing drugs.

Given that the issue of contraception so important to women’s health, we asked Susan Wysocki, President at iWoman’s Health and former CEO of the National Association of Nurse Practitioners in Women’s Health, to weigh in. Here’s what she said…

Sandra Fluke

While we won’t know until some time in June whether the Supreme Court will find the Accountable Care Act constitutional, unconstitutional, or simply parts of it unconstitutional, the debate about whether contraceptive care should be a covered service rages on.

Some argue that paying for contraception is paying for a lifestyle issue. Others have argued that women like Georgetown Law student Sandra Fluke could well afford to pay for her own birth control. Religious issues, central to much of the debate, argue that individuals should not have their taxpayer dollars pay for something that goes against their conscience. Even some women I have spoken with have said that they were able to prevent an unintended pregnancy by paying for their own contraceptives. Why shouldn’t other women?

Related: Sandra Fluke, Chelsea Clinton – What’s Holding Women Back From Running for Office?

According to the Guttmacher Institute, nearly half of the pregnancies in the United States are unintended. Some of those unintended pregnancies as mistimed, meaning that the woman would have preferred having a child at a later time in her life. About 20 percent of those pregnancies are unwanted. In 2006, the latest year that data are available, indicates that 43 percent of unintended pregnancy ended in abortion. The U.S. unintended pregnancy rate is higher compared to many other developed countries.

There are few people who would argue that unintended pregnancy isn’t a problem. Although there are many disparate opinions about how the rate of unintended pregnancy can be reduced.  As someone who has been involved in helping to reduce unintended pregnancy for much of my career, I do know that access to contraceptive services helps. I also know that methods like intrauterine contraception (IUDs) and implants, are the most effective methods of reversible contraception, but they are the least covered by insurance now.  The methods require no user intervention–remembering to take that pill or use that condom–and thus, human error is taken out of the equation.  However,  many women cannot  afford the up front cost for these methods.  Considering the number of years of efficacy  these methods provide, over time they are the more cost effective than any other methods.  If all FDA approved methods of contraception are covered benefits, many more women would have the opportunity to choose these very effective methods.

Related: Should the Morning After Pill Be Given to Girls Under 17 Without a Prescription?

Susan Wysocki

What puzzles me the most about the arguments about taxpayer dollars and contraception is that the discussion often does not include the cost of unintended pregnancy to the taxpayer — roughly $11 billion. That’s $11 billion of unintended taxpayer dollars. Looking at the cost for individual subscribers of a health plan, the Washington Business Group on Health and the National Business Group on Health determined that when the medical costs of unintended pregnancies are taken into account, including the costs of prenatal care, pregnancy complications, and deliveries, the cost of providing contraceptives and contraceptive care is a zero sum cost.

Global Health Outcomes estimates that an employer paying for health benefits could save $97 per year, per employee due to the indirect costs such as loss of productivity due to an unintended pregnancy.

Some may call me a liberal for supporting the coverage of contraceptive services. I am simply a taxpayer who wants my tax dollars at work doing something for women and saves us all billions per year.

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Category: Health, Views on the News, Women's Health

Susan Wysocki, WHNP, FAANP

About Susan Wysocki, WHNP, FAANP: Susan Wysocki is the President at iWoman's Health, which highlights insight, information and interconnections about health issues for women. iWomansHealth will be launched on the web in the near future, stay tuned for updates. Susan [...]
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