Dr Kevin Campbell
Chief Medical Correspondent, Bold.Global
President Elect Trump has made it clear that a top priority for his administration will be the dismantling of the controversial Affordable Care Act. Just this past week, I discussed what healthcare under Trump may look like on BoldTV with Carrie and Clay.
However, one issue that has many young women worried is how the changes in Obamacare could affect access to contraceptives. Currently, the ACA mandates that insurers MUST provide coverage for ALL FDA approved birth control methods/devices without copay or co-insurance in network for women who want it. Following the election, many young women have flocked to their OB/GYN offices with real concerns and questions about what to expect in the future.
What about contraception for women in the United States Today?
According to the Centers for Disease Control (CDC) nearly 99% of sexually active women used at least one form of birth control between the years of 2006 and 2010. There are many FDA approved choices for women who wish to avoid pregnancy including: oral contraceptive pills, an Intrauterine Device (IUD), condoms, diaphragm, hormone implants and hormone shots—just to name a few. The ACA mandates coverage of ALL of these devices and this has provided women with a variety of choices. It is now fairly common for a woman to discuss options with her OB/GYN physician and determine what is best for HER. Many women now worry that with changes to the ACA, they may not have the same access to contraception and, according to leading OB/GYN physicians, the tone of office conversations has changed in the last two weeks. Now women are asking about how to get the more expensive and most long lasting forms of contraception before the inauguration. This has some physicians worried that women may be making decisions based on politics rather than on what is best for them and their bodies.
What Do We Know About Trump and Contraception?
At this point, neither Congress nor Trump has disclosed what they would do with the contraception provisions in the ACA so we really do not know very much. In the past year Trump has made public comments on contraception stating that he is in favor of allowing contraceptives to be sold over the counter without a doctor’s prescription—the same position held by the American College of Obstetricians and Gynecologists. In the last year, there has also been activity by some Republicans in Congress to draft a bill to allow sale of oral contraceptive pills without a prescription so there may be some legislative support already in place. Vice President Elect Mike Pence has been outspoken against abortion and other women’s reproductive rights issues and this is a legitimate cause for concern for many women. The bottom line at this point is that we just do not know what to expect–and the lack of clarity on these issues has understandably produced anxiety among young women.
The Rush for IUDs
Intrauterine devices or IUDs are longer lasting forms of birth control. These devices, which are placed in the uterus by a physician, can provide effective birth control from 3-12 years depending on the type. An IUD blocks sperm and changes the lining of the uterus in order to prevent the attachment of a fertilized egg and thus prevent pregnancy. These devices can be removed at any time but must be done so by a physician–they are expensive when compared to other methods. Many women worry that they will not be able to afford them if the ACA coverage is lost during the repeal and replace process. OB/GYN physicians are reporting an alarming increase in calls and office visits to discuss IUDs. Lots of women are pushing to get these devices placed urgently due to a fear of loss of coverage in the coming year. All forms of contraception can have side effects and IUDs are not perfect–side effects include possible irregular or increased menstrual bleeding. IUDs can cost as much as $1,000 in out-of-pocket expenses for those who are uninsured.
At this point, I think it is vital for young women who want to avoid pregnancy to spend time discussing options with their personal physician. It is important to make decisions that are BEST for your individual situation and your own body. While politics are unfortunately beginning to play a larger role in medical decision-making, it is still essential to consider and discuss all contraception options with your OB/GYN. Ultimately, I believe that a woman’s right to choose how and when to prevent pregnancy should be HERS alone–the government should have no role in this type of decision making.
Dr Kevin Campbell, MD, FACC is chief medical correspondent for Bold.global. Dr. Campbell is an internationally recognized Cardiologist who specializes in the diagnosis and treatment of heart rhythm disorders. Dr. Campbell is the Medical Expert for WNCN and appears weekly on the CBS morning news and also makes frequent appearances nationally on Fox News, CBS, and HLN.