March 9, 2016

The news on the unplanned pregnancy front is nothing but good. Vox:

Unintended pregnancies fell 18 percent between 2008 and 2011 — the steepest decline in decades — and it's largely because women are choosing better, more effective birth control.

More and more women are choosing birth control based on long-range plans for their own lives. Access to medical care under Obamacare is a huge part of this. Having a private conversation with a doctor, a woman can declare her desire to remain pregnancy free for a number of years (like when she is attending college) and a doctor can prescribe a long term contraceptive like an IUD or patch.

Long-acting reversible contraceptives (LARCs) are remarkably effective, in that a woman does not have to remember to take them or get a prescription refilled. They do not impact a woman's long-range fertility, but they do prevent pregnancy for the years that a woman wants to pursue other goals.

Obamacare, and specifically the contraception mandate, has made these devices accessible to many more women:

One of the biggest obstacles to LARC use, historically, has been price. Planned Parenthood has estimated that IUDs can cost between $500 and $900 out of pocket. Insurance plans tended to charge patients more for IUDs than for birth control pills, just because the devices have such high upfront costs.

Obamacare is changing that in two ways. The law's insurance expansion means millions more Americans now have coverage, and that will help pay their medical bills. Additionally, Obamacare mandates that insurers cover all contraceptives at no cost to patients. This means that insurers can't charge patients more for an IUD because the device costs more than birth control pills.

While the increase in the use of LARCs preceded Obamacare by a couple of years (thanks to 'activist' doctors who ask their patients if they want to become pregnant or not), it's clear that increased access to healthcare along with a mandate for coverage for LARCs is leading to some terrific outcomes for women. Thanks, Obamacare.

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