On low-cost birth control

I just came across a very interesting article on Planned Parenthood and the availability of low-cost or subsidized birth control. Check it out: Planned Parenthood’s Pricey Pills. The article starts off talking about teenagers who stopped taking birth control because they couldn’t afford it — they don’t want to use their parents’ insurance, for fear they’ll find out — and they don’t have the money to cover the cost of the exam and the full-price prescription.

The article quotes a PP spokesperson who says that when the patient can’t afford it, doesn’t have insurance and doesn’t fall into any of the established categories for free/subsidized birth control, the individual clinics are supposed to step up and figure out how to help the patient. But this article has found that some women aren’t getting this from PP.

Based on what I read in the article, it looks like the big problem is a lack of communication due to staff turnover and the fact that the rules, regulations and options for covering this stuff are complicated. That makes it difficult for a new staffperson to quickly catch on and give out the proper information. The turnover is driven partly by the eternal issue of funding. — staff jump ship because they can take their skills to another medical office or clinic and make vastly more money. Plus, there’s not enough funding to give every woman who walks in the door free birth control. (This article notes that the PP office in Austin recently took a 45% cut to their federally-supplied funding. They cut their hours nearly in half, and can’t support nearly as many women in Austen as they did previously.) So that means that PP has had to come up with some guidelines to figure out who gets the free pills.

But still, given the funding problems (which, sadly, will probably never go away) and given that the laws governing all these things are different in every state, and that coverage is different for every type of insurance, it’s already complicated enough. Without knowing all the ins and outs (I do know PP has a sliding scale for payment of some services and prescriptions), I wonder if there’s anything PP could do to simplify their regulations for coverage. The simpler it is to understand who’s eligible for what, the easier it is for staff to give out the right info to the right people, from day one.

All that being said, I was disturbed to hear the difficulties the women in the story encountered when they visited PP. I have never been to one, but I’m grateful that they’re around and for the work that they do. It’s sad to see that it looks like not everyone who works there has their heart in it. I mean, come on, a placard that says “A lack of planning on your part does not constitute an emergency on mine” is funny in the right office setting — but DEFINITELY innappropriate in a family planning clinic like PP! I wonder how long that sign’s been up, and why the director of that clinic didn’t take it down as soon as she saw it. Can you imagine showing up at that clinic, worried that something went wrong with your birth control (or lack thereof) to be greeted by that sign and, I can only assume, a grouchy receptionist? PP is supposed to be a safe place — no woman should walk into one and find anything less than a caring, supportive, non-judgemental atmosphere. We all make mistakes and bad decisions.

The article was interesting and talked briefly, in general terms, about the cost of birth control — as prescriptions (for everything, including birth control) get more and more expensive, more and more women are priced out. Take this as an example: my birth control is a brand name drug with no generic available, so if I want to stick with it I’m at the mercy of the pharmaceutical that produces it. Imagine my delight at CVS last month when I discovered that the cost increased, with no word of explanation from the pharmacy. Luckily, it was only $2. And luckily, I’ll get reimbursed for everything over $15 (or $10, depending on who processes the claim at the insurance company). With the exception of my first job, I’ve been lucky enough to have prescription coverage that treats birth control as a regular prescription — there’s not a higher copay just because it’s birth control. But I live in the Northeast. What if I lived somewhere less progressive? What if my birth control wasn’t covered by my prescription plan? What if I couldn’t even get the prescription filled without being made to feel like a whore?

As part of that discussion, the author lists a couple of resources for affordable birth control pills. SmartWoman Rx carries three generics of the pill and is pretty damn cheap. Not every formula will work for every woman, but for some women it might be worth trying a new pill. Not-2-Late (run by Princeton’s Office of Population Research and the Association of Reproductive Health Professionals) is a resource for information about emergency contraception (which can be even harder to get than plain old birth control), and includes a directory of providers who are willing to prescribe it. Then you can spend your energy finding a pharmacy that will fill it without giving you a hard time.

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