The IUD I just had inserted hurt like hell. But that pain was nothing compared to the mind numbing, demoralizing burden of trying to access birth control in the US. That’s not just a women’s problem, that’s a shameful reality for all of us.
Last month, my new insurance provider, UnitedHealthcare, charged me $30 for my monthly NuvaRing. Apologies to the Walgreens pharmacist who watched me blow my top. Under the 2010 Affordable Care Act (ACA), which includes a birth control coverage mandate, and subsequent clarifying guidance from the Department of Health, not only is that not right, it’s not legal. Employers and their insurers must cover FDA-approved contraceptive methods in full, without co-pay.
Ever since that mandate was announced, it’s been a slog to get it implemented. Religiously affiliated employers (save a few exceptions) and some colleges continue to appeal, without much luck, while no-good very-bad highly-profitable insurance companies are dragging their feet, clinging to technicalities and loopholes.
Why? Why don’t they want to cover our birth control, when it saves lives, actually saves money, prevents unintended pregnancies that lead to abortion, is basic health care, and also, is none of their business?
I spoke with a very sweet but entirely ill-informed UnitedHealthcare customer service rep who calmly, incorrectly explained to me that because they cover other hormonal methods, they don’t need to cover NuvaRing. Um, NOPE.
If I wanted to try and appeal, she said, I should write a letter to a PO Box in Arkansas and wait for eight weeks. Maybe they’d make an exception for just me.
A letter. To Arkanas. And *maybe* they’d make an *exception* for *just me.*
The saddest thing about our overburdened, underperforming, and labyrinthian healthcare system is that it doesn’t outrage us enough. As a people — and especially as women — we have become so inured to high healthcare costs and sub-par access that we can hardly believe it’ll change.
Women of reproductive age in the US spend nearly 70% more on out-of-pocket healthcare expenses than men, mostly due to birth control costs. This adds an entirely unnecessary and untenable burden on half the population, with ramifications in all directions.
Several long holds, unanswered messages and phone calls over weeks later, I was connected with Corporate Affairs. I argued my case forcefully (because there is hardly an issue I care more about than this) numerous times. I invoked the large, vocal network of reproductive health advocates of which I am a part. I read verbatim from Health and Human Services guidelines. I even referenced the irony of the 50th anniversary of Griswold v. Connecticut. I was told I’d receive a letter in the mail stating their decision.
I insisted this wasn’t about me and my policy, but was about the institutional policy and the principle of what’s right. My voice was just one angry feminist’s, but I was calling with the fervor of millions of people whose reproductive rights have been — and are — being hampered by bureaucratic and oppressive policies in the US. I stayed on hold those long minutes in the spirit of two principles I hold dear: health is a human right, and I own my own damn body.
It was my privilege to stay on hold, to argue my case. It was my pleasure to hound UnitedHealthcare for a right I knew I had, although they told me I didn’t. All I could think about was the millions of women who still may not know that birth control is free or who don’t have the time or energy to navigate the dismal mazes of insurance company customer services lines.
Four weeks later, I received a letter. Although United wouldn’t reimburse me for the $30 NuvaRing I purchased in June, they were happy to announce that they’d cover it fully there after. By that time, though, I was so exhausted from arguing and so depressed with the state of reproductive access in the country that I’d already scheduled an IUD appointment.
Accessing affordable birth control in the US is a total slog. But let’s be honest, access reproductive rights more broadly is also abysmal. There’s an active assault on our rights and on our access. Under the ACA, birth control access now should be what it always should have been: free and accessible, granting women full autonomy over their own fertility. Unfortunately the President‘s directive is not forceful enough, so it’s on all of us to know our rights and be vocal about them in all ways we can.
New advocacy watchdog efforts such as CoverHer, managed by the National Women’s Law Center, have cropped up to ensure accountability. If you aren’t getting birth control coverage, let them know by phone and email.
An IUD is one of the most effective and cost-effective ways to prevent pregnancy. It’s also, as it turns out, a great way to avoid the unpleasant intrusion of ill-informed insurance companies from your daily life.
