Why birth control is affordable and coverage at 100% does increase costs – the contraception mandate

The idea that birth control is unaffordable to the vast majority of women is not only absurd, but a bizarre argument. It is only surpassed by the idea that mandating 100% coverage will save money for health plans.

Even if a women paid 100% of the cost of the pill, at maximum it would be $600 a year, far less if a generic is used. An office visit to obtain the pill is generally covered as any other office visit because it would never be submitted as just a visit to prescribe a contraceptive.

Given nearly 90% of employer plans already cover contraceptives, it would be rare the coinsurance was greater than 30% thus lowering the cost to a maximum of about $180 per year and much less if both mail order and generic is used. In most cases the coinsurance for contraceptives is the same as for all other prescriptions.

Further, whether or not some one item is affordable to a person must be weighed in relationship to how that person spends all her available funds. In other words, setting financial and personal priorities.

Here is the counter argument from the Center for American Progress a liberal organization that supports the President and his policies.

Many people seem to think birth control is affordable, but high costs are one of the primary barriers to contraceptive access. It is for this reason that the Obama administration recently followed the recommendation of the Institute of Medicine to ensure that birth control will be covered as a preventive service with no cost-sharing beginning August 1, 2012.

Although three-quarters of American women of childbearing age have private insurance, they still have had to pay a significant portion of contraceptive costs on their own.

A recent study shows that women with private insurance paid about 50 percent of the total costs for oral contraceptives, even though the typical out-of-pocket cost of noncontraceptive drugs is only 33 percent.

In some cases oral contraceptives approach 29 percent of out-of-pocket spending on health care for women with private insurance.

Women of reproductive age spend 68 percent more on out-of-pocket health care costs than do men, in part because of contraceptive costs.

High costs have forced many women to stop or delay using their preferred method, while others have chosen to depend on less effective methods that are the most affordable.

Surveys show that nearly one in four women with household incomes of less than $75,000 have put off a doctor’s visit for birth control to save money in the past year.

Twenty-nine percent of women report that they have tried to save money by using their method inconsistently.

More than half of young adult women say they have not used their method as directed because it was cost-prohibitive. Women are struggling to pay for birth control at a time when they need it most.

Not one of the generalizations above tells you what a woman actually spends out of pocket each year.

Now with regard to the argument that covering contraceptives at 100% saves an employer plan or insurance company money because it is cheaper than a pregnancy, let’s get real. Assume a plan currently covers 75% of the cost of contraceptives and must now cover the additional 25%.

Unless you seriously believe that plan participants become pregnant because of the $125 per year (often far less) expense represented by the 25% cost sharing and now will not; plan expenses just went up by 25% of the cost of a prescription multiplied by the number of prescriptions filled…period.