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The Economics of Preventive Care

By Perry Sacks

Today, the Supreme Court will hear arguments on a major case impacting young women’s health and economic security – access to birth control. Two companies, Hobby Lobby, an art supply store, and Conestoga Wood, a furniture manufacturer, will argue before the U.S. Supreme Court that they can refuse to cover some forms of birth control in their employee health plans.

At the center of this debate is one provision of the Affordable Care Act (ACA) requiring all large employers to cover preventive health services, including all FDA-approved methods of birth control, without a co-pay. Yet these for-profit companies, with tens-of-thousands of employees between them – Hobby Lobby employs over 21,000 people across the country – do not want to provide their employees access to birth control, a basic preventive health service, citing religious objections.  Under the law, religious non-profits were exempted from this requirement, but for-profits were not.

So what does access to birth control mean for the health and economic prospects of young women?

The short answer – birth control coverage is a big deal. The cost of birth control can be high, often as high as over $600 per year. Copays range from $15 to $50 a month. And other methods, like IUDs, can cost several hundred dollars up-front, even with help from insurance.  Ninety-nine percent of all sexually active women use birth control at some point in their lives, with 62 percent of reproductive-aged women currently using some method. These rates are across races, religions and income levels. What’s more, 14 percent of women who use birth control (1.5 million women) rely on it to treat or control medical issues, including menstrual pain, polycystic ovarian syndrome, irregular menstruation, skin conditions and endometriosis.

And there is no denying that cost is a factor: more than one-third of women voters in the US have struggled with the cost of prescription birth control at some point in their lives. That number rises dramatically among younger women, with more than half mentioning a time when they could not afford to use birth control consistently because of cost. And, we know that low-income women face disproportionate barriers to accessing birth control.

Moreover, we also know that access to contraception is crucial to expanding women’s educational and professional opportunities and closing gender gaps that persist in many fields. That’s because a woman’s ability to choose if and when to start a family can be a factor in her decision to attend college and pursue her chosen career.

The ACA was a groundbreaking achievement for our generation’s health precisely because it expands access to health care and economic opportunity for young adults, and particularly for young women. The Supreme Court has the opportunity today to sustain a crucial access point to contraception for potentially millions of young women.