What are some of the biggest changes that have gone into effect as a result of the November 2012 election? The most important thing is that birth control is now going to be covered by all insurance plans for women no matter where they work, at no cost sharing or no copay. IÃ¢â‚¬â„¢ve seen anecdotally on the road women will stop and me and say, Ã¢â‚¬Å“I just went to have my annual and when I went to get my birth control they told me thereÃ¢â‚¬â„¢s no cost.Ã¢â‚¬Â WeÃ¢â‚¬â„¢re already seeing the impact. And by 2014, all insurance plans will include this new benefit. We know at Planned Parenthood that most women, if they get pregnant when theyÃ¢â‚¬â„¢re not intending to be, itÃ¢â‚¬â„¢s because the birth control method theyÃ¢â‚¬â„¢re using isnÃ¢â‚¬â„¢t working or theyÃ¢â‚¬â„¢re in between methods. The exciting thing about this new benefit is it allows women to choose the birth control that really works best for them, rather than the one thatÃ¢â‚¬â„¢s the cheapest. And I think this is so important because there are many more methods now than there ever has been. For some women a daily pill is no problem, for others the security of an IUD and not having to worry about it for several years is a great option. There are a lot of choices and weÃ¢â‚¬â„¢re really pushing to make sure that women have all of these options and help them so that they can plan when they want to get pregnant.
Planned Parenthood recently submitted 350,000 comments in support of the ACA birth control benefit to the Department of Health and Human Services. With so many advocates fighting to ensure that this benefit remains available, is there a chance that it may still be revoked or limited? There are a couple of important things coming up. One is the final rule on the birth control benefit that should be published sometime late this summer. I donÃ¢â‚¬â„¢t have any sense that the administration is changing or modifying their position. TheyÃ¢â‚¬â„¢ve already made very reasonable accommodations to churches who have an objection. The more worrisome aspect of this is there are now more than 40 lawsuits by private employers who for their own reasons do not want to cover birth control. They say they have an objection. And these cases are now winding their way through the courts. We believe strongly at Planned Parenthood that birth controlÃ¢â‚¬”since it is frankly the most commonly prescribed medicine that women take, 99% of women [have used] itÃ¢â‚¬”should be treated just like all other preventive care for women. One of the most interesting statistics is that 58% of women in America use birth control in part if not exclusively for medical reasons other than preventing unintended pregnancy. Many women are taking birth control for other reasons, and itÃ¢â‚¬â„¢s unthinkable that an employer would be able to keep women from getting that benefit. WeÃ¢â‚¬â„¢re working very hard to make sure that people in this countryÃ¢â‚¬”women and menÃ¢â‚¬”are advocating for the birth control benefit so that we donÃ¢â‚¬â„¢t go backwards.
If any of these court cases go through, what kind of impact might that have on future lawsuits against the birth control benefit? WeÃ¢â‚¬â„¢re very hopeful that despite these lawsuits by individual employersÃ¢â‚¬”which again, their goal is to take down the benefit for every woman in AmericaÃ¢â‚¬”weÃ¢â‚¬â„¢re really hopeful that the courts will see birth control for what it is, which is a basic healthcare need for women and that they wont treat it differently than other healthcare that women need. ItÃ¢â‚¬â„¢s amazing, a lot of times we hear politicians say that birth control is a social issue, itÃ¢â‚¬â„¢s an economic issue. But itÃ¢â‚¬â„¢s only a social issue if youÃ¢â‚¬â„¢ve never had to pay for it. ItÃ¢â‚¬â„¢s extraordinary to hear from women who are now getting their birth control at no copay and theyÃ¢â‚¬â„¢re able to stay on birth control. And what we know from other countries is that when women have birth control access we reduce the rate of unintended pregnancies and frankly reduce the need for abortions.
Under the ACA, will birth control methods like the IUD and implants also be covered without a copay? If so, do you think weÃ¢â‚¬â„¢ll see more women trying these methods in the future? ThatÃ¢â‚¬â„¢s part of whatÃ¢â‚¬â„¢s being sorted out. We think itÃ¢â‚¬â„¢s really important that women get every possible option because women have different needs when it comes to birth control. Different methods work better. ThereÃ¢â‚¬â„¢s a logic to this, which is that birth control saves money. It helps to prevent pregnancy. But there are still decisions to be made as this benefit gets rolled out and weÃ¢â‚¬â„¢re working state by state and with Health and Human Services to advocate for the widest possible interpretation in allowing women to get whatever birth control method that they want.
In April, a federal judge ruled that emergency contraception should be available over the counter for women of all ages. Some have argued that easier access to EC may have negative consequencesÃ¢â‚¬”like women using it as their primary form of birth control or using it too often. Do you foresee this being an issue? Our experience at Planned Parenthood, and we see 3 million patients a year, is that women do not use emergency contraception as [their primary] birth control. Frankly, itÃ¢â‚¬â„¢s relatively expensive and we certainly donÃ¢â‚¬â„¢t advocate for it. We just think its important there as an option. These two topics go hand in hand. If women actually get on birth control that works for them and they donÃ¢â‚¬â„¢t have to go off of it for either economic reasons or because it has adverse health impacts, I think emergency contraception is simply important to be there in an emergency. WeÃ¢â‚¬â„¢ve had couples come in, a condom breaks, those are emergencies, and itÃ¢â‚¬â„¢s really important to have that as an option. The medical research has shown that people use it responsibly, they donÃ¢â‚¬â„¢t use it as a form of birth control, and that has been our experience at Planned Parenthood as well.
There has been talk of Planned Parenthood and other womenÃ¢â‚¬â„¢s health clinics being defunded recently. In what states is Planned ParenthoodÃ¢â‚¬â„¢s funding being threatened? ItÃ¢â‚¬â„¢s been interesting. A couple of years ago when the House of Representatives attempted this, it really created an enormous backlash around the country. Of the one in five women in this country who has been a patient of Planned Parenthood, I feel like we heard from every single one of them, because women were concerned. Planned Parenthood plays a really important role in America, and for many young women itÃ¢â‚¬â„¢s the first place they go to get healthcare. So weÃ¢â‚¬â„¢re not seeing this same kind of hysteria at the national legislature. But unfortunately some state legislatures are still pursuing this kind of thing. For example, the Ohio legislature is considering this kind of measure, which is really extraordinary when you think about the role that Planned Parenthood plays in the state of Ohio. In many parts of that state, weÃ¢â‚¬â„¢re a primary healthcare provider. Also the state of Arkansas has been considering a similar measure. We saw in the state of Texas in particularÃ¢â‚¬”where the governor and the legislature ended the entire womenÃ¢â‚¬â„¢s health programÃ¢â‚¬”that impacted more than 100,000 women in that state who rely on not only Planned Parenthood but other womenÃ¢â‚¬â„¢s healthcare providers for their pap smears, their breast exams, their annuals, and their birth control. So there are pockets of the country where the attacks not only on Planned Parenthood as a healthcare provider but womenÃ¢â‚¬â„¢s health more broadly are continuing to go through legislative sessions.
How can women get involved in states where Planned Parenthood funding is under fire? WeÃ¢â‚¬â„¢re actively involved with women and men in the states where these kinds of very regressive bills are being considered. There has been an enormous amount of public comment and involvement in the state of Arkansas, certainly in Ohio. Even in states where weÃ¢â‚¬â„¢ve had terrible bills passed like the state of North Dakota or Alabama. The most important thing that folks can do is join us on our Facebook site where they can get involved or go to PlannedParenthoodAction.org, which is our site that tells people whatÃ¢â‚¬â„¢s happening in their local community and how they can get involved.
If this happens, what options would be available to women in the affected areas? I think the difficulty is for the kinds of care that Planned Parenthood providesÃ¢â‚¬”particularly when youÃ¢â‚¬â„¢re talking about young women who essentially need birth control and need their annualÃ¢â‚¬”the waiting period to get into a publicly-funded health center can be weeks if not months. And we certainly understand that if you need to go on birth control, most women donÃ¢â‚¬â„¢t want to waste several months before they can see a doctor, get a prescription, and get birth control. So thatÃ¢â‚¬â„¢s been what weÃ¢â‚¬â„¢ve been hearing from legislatures and women in these states. The concern that if these kinds of bills pass, thereÃ¢â‚¬â„¢s really not going to be any organization that wants to come in and fill that gap. That is actually exactly what happened in Texas. In fact, the public health community said, Ã¢â‚¬ËœLook, we canÃ¢â‚¬â„¢t have women going to emergency rooms to get birth control. This is crazy.Ã¢â‚¬â„¢ And these kinds of regressive bills that are passed in the state of Texas not only shut down Planned Parenthood but there were more than 50 health centers shut down. Some of them were Planned Parenthood, but many of them were other womenÃ¢â‚¬â„¢s healthcare providers that simply couldnÃ¢â‚¬â„¢t stay open. So the impact is outrageous. There is no one in this country who wants women to get pregnant when they donÃ¢â‚¬â„¢t want to be, when they donÃ¢â‚¬â„¢t intend to be. There is no one who wants to shut women off from getting a breast cancer screening that could help with early detection and could potentially save lives. ThatÃ¢â‚¬â„¢s really the kind of care thatÃ¢â‚¬â„¢s being gone after in some of these states. And weÃ¢â‚¬â„¢re completely committed and so are the American people, I believeÃ¢â‚¬”to making sure that women donÃ¢â‚¬â„¢t lose access to care that they currently have. ItÃ¢â‚¬â„¢s sort of ironic that we have an Affordable Care Act thatÃ¢â‚¬â„¢s now going to insure millions more people, but weÃ¢â‚¬â„¢ve got to make sure that not only do women have insurance, but they actually have a place to use it.
While weÃ¢â‚¬â„¢re making strides in terms of access to birth control and womenÃ¢â‚¬â„¢s healthcare, some states are trying to adopt stricter rules on abortions. What are some of the recent abortion laws that are being voted on and which state limits are Planned Parenthood most concerned about? North Dakota has been the most extreme and theyÃ¢â‚¬â„¢ve passed so many bills including a bill that really is just extraordinary to meÃ¢â‚¬”a bill that would prevent couples from making decision, often very difficult decisions, about terminating a pregnancy where there is a severe fetal anomaly. These kinds of decision are really illustrating the danger of when you have politicians rather than women and their families making decisions about pregnancy. [WeÃ¢â‚¬â„¢re seeing] bills whose purpose and intent is to ensure that there is no safe and legal abortion available to women in the states of Mississippi and Alabama. The state of Arkansas passed a 12-week ban and they passed a 20-week ban. [These are] bills that we believe are certainly unconstitutional but demonstrate the lengths to which some politicians will go to essentially overturn what has been a 40-year right in this country of women to make their own decisions about pregnancy. Essentially they are now banning abortion in these states before a woman often even knows that sheÃ¢â‚¬â„¢s pregnant. I think it shows the mean-spirited and really heartless nature of some of these very extreme laws that take women out of the role of making decisions about their pregnancies. I say to these folks, if you really wanted to reduce the need for abortions in this country youÃ¢â‚¬â„¢d be volunteering at a Planned Parenthood, where we do more to provide birth control and help women prevent unintended pregnancy and plan their pregnancies than any organization in the country. ItÃ¢â‚¬â„¢s extraordinary that in the 21st century there are politicians who canÃ¢â‚¬â„¢t find anything more productive to do than to go after womenÃ¢â‚¬â„¢s health.
What laws do you think we might see brought up to the Supreme Court in the near future? There are bans on at what point women can make a decision to terminate a pregnancy. I think one or more of these pieces of legislationÃ¢â‚¬”which we believe would set a whole new restriction and standard for womenÃ¢â‚¬”I would not be surprised to see one or more of these bills heard before the Supreme Court. We would certainly hope that this court would recognize 40 years of jurisprudence in America, the rights that women would have, and the thought that we canÃ¢â‚¬â„¢t imagine this country going backwards. [It would be] taking away a right that women have had for 40 years, or making it depend on what their zip code is.
What would Planned ParenthoodÃ¢â‚¬â„¢s next steps be if one of these issues did go to the Supreme Court? ItÃ¢â‚¬â„¢s a little ways in the future but we certainly litigate every bill that we can and we work in partnership with our colleagues at the ACLU and the Center for Reproductive Rights to ensure that women are represented in these cases. WeÃ¢â‚¬â„¢re going to be there for women no matter what, and we try to plan for any eventuality. Despite the bad legislation, weÃ¢â‚¬â„¢re very excited about the birth control benefit and for the literally millions of more women who will be insured in this country. Our goal is make sure that Planned Parenthood is there to serve them.
How can women make sure that theyÃ¢â‚¬â„¢re receiving the birth control benefit? You should definitely check with your insurance company. If you have any questions you should do that now, because some of these plans are rolling in and rolling over at different points. A lot are rolling over this summer so itÃ¢â‚¬â„¢s good to find out and make sure you know whatÃ¢â‚¬â„¢s available to you so you can take advantage of that.
What else should women know about the Affordable Care Act and about their healthcare options? There are a couple of other very important things that are now part of our healthcare system. One is that women can no longer be charged more for insurance than men, and thatÃ¢â‚¬â„¢s a huge difference. There is no more gender rating and thatÃ¢â‚¬â„¢s a direct effect of the Affordable Care Act. And one of the most important issues that we fought for was to make sure that women couldnÃ¢â‚¬â„¢t be denied healthcare insurance because of a preexisting condition, which in the past could include everything from pregnancy to being a survivor of domestic assault to having had breast cancer. Our goal is to make sure that all women can get insurance and get the healthcare they need. Those are some really important things for women to educate themselves on. And make sure that folks understand that if they go in tomorrow and [are not charged a copay]Ã¢â‚¬”that didnÃ¢â‚¬â„¢t happen by accident. That happened because of the Affordable Care Act and the really courageous folks at the United States senate, including some very important women senators who made sure that womenÃ¢â‚¬â„¢s healthcare and womenÃ¢â‚¬â„¢s preventive care was advanced.
How can women get involved to protect their rights to birth control and safe, affordable healthcare? Certainly signing up on Planned ParenthoodÃ¢â‚¬â„¢s website. People are posting their stories about how the birth control benefit is benefitting them. I think collecting those kinds of stories nowÃ¢â‚¬”as this benefit is becoming part of their livesÃ¢â‚¬”is really important. And putting a human face on a policy that I think too many people donÃ¢â‚¬â„¢t understand is really important. So weÃ¢â‚¬â„¢ve encouraged folks to go to PlannedParenthoodAction.org for more information about how to make sure youÃ¢â‚¬â„¢re weighing in on the birth control benefit and other healthcare issues that relate to womenÃ¢â‚¬â„¢s health.
Do you think that contributing these stories and making your voice heard can make a difference if some of these cases are eventually brought to the Supreme Court? Absolutely. Certainly in the Supreme Court theyÃ¢â‚¬â„¢ll be looking at judicial precedent, but I think it is critical that judges understand what the real life impact is of these kinds of laws. And thatÃ¢â‚¬â„¢s what weÃ¢â‚¬â„¢ve seen in state after state. When we actually were able to bring these issues on the ballotÃ¢â‚¬”whether it was in Mississippi or in South DakotaÃ¢â‚¬”people understand that women need to be in charge of their own healthcare. And they need to be able to make the decisions about their pregnancies, about their birth control, about what provider they want to go to. When women and men speak out, these kinds of really extreme measures are rejected. There is nothing more important than having folks join our 7 million supporters in advocating for womenÃ¢â‚¬â„¢s health.
photo: Planned Parenthood