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November 10 2016

No, Women Don't Have To Run And Get An IUD

Washington Examiner
Hadley Heath

In the aftermath of Donald Trump's election victory, some feminists are suggesting the new administration may "strip women of [their] reproductive rights," including the right to get an intrauterine contraceptive device, or IUD. They suggest women hastily get IUDs before Trump takes office.

This requires a little backstory: The Affordable Care Act mandates that all insurance plans offer first-dollar coverage for all FDA-approved forms of contraception for women, including IUDs. This means women with ACA-compliant insurance plans can get an IUD without any cost-sharing or copays.

Some on the Left are fearful that Trump and a Republican Congress will repeal the ACA. They are right to be fearful. This would fulfill one of Trump's campaign promises and be a positive change to public policy. The ACA, despite good intentions, has only resulted in skyrocketing costs, limited options and dysfunction. Repealing it would be the first step toward replacing the law with a better plan.

But the end of the ACA would not be the end of women's access to contraception. It might change our health insurance benefits, but it will not change our rights.

First, women are free to go to their doctor's office or pharmacy and obtain birth control without any insurance coverage. They can pay out of pocket, as we should for routine, expected health care expenses.

The total cost of an IUD today without insurance can be up to $1,000, but it may be a more cost-effective form of birth control over time, as IUDs last for years. Low-income women may qualify for payment plans or discount prices.

It's possible that, absent the ACA's birth control mandate, the price of IUDs would decrease significantly because providers would have to compete on price to attract customers directly. Insurance, or third-party payment, actually gets in the way of price transparency and can lead to bloated prices.

Then again, insurance companies, even absent the ACA, could still choose to cover various forms of birth control. Some supporters of the ACA's birth control mandate say it's beneficial to insurers bottom lines, as medical claims for birth controls are cheaper than medical claims associated with pregnancy. Therefore, they argue, it's in insurance companies' interests to offer coverage for contraception. If so, then insurance companies would almost certainly do so even absent a mandate.

Repealing the ACA and the birth control mandate would not strip anyone of his or her rights. A right is something available to people in nature. The government can protect our rights, but the government does not bestow them. If the government pays for something on behalf of citizens, or forces another party to pay for it, this thing is not a right, but a benefit.

Repealing the ACA might change health insurance benefits, as it would offer insurers more freedom to design and sell an array of plans. Some would be cheaper and cover less, while some would be more expensive and cover more. But then it would be up to customers to choose the best plan for them. Truly, this would be a win for women and men, because it would put more of the decisions about our health care (and how to pay for it) into our hands.

In any case, getting an IUD is a serious decision. Women shouldn't do it hastily or out of fear of change in our government. Uncle Sam should have never gotten so involved in birth control politics as he did with the Affordable Care Act, and now we see why. A government big enough to give you what you want can also take it away.

Independent Women's Forum is an educational 501(c)(3) dedicated to developing and advancing policies that aren’t just well intended, but actually enhance people’s freedom, choices, and opportunities. IWF is the sister organization of the Independent Women’s Voice.​
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