One in 5 women at risk of unplanned pregnancy would use a different form of birth control if cost was not a factor, according to a new study published in Contraception x.

The United States Supreme Court (SCOTUS) recently ruled in Little Sister of the Poor vs. Pennsylvania that employers can refuse to cover birth control for religious and moral reasons. In those cases, birth control will be an out-of-pocket expense. 

In recent years, affordable access to birth control has increased due to the Affordable Care Act, which includes a contraceptive coverage mandate. According to a press release, this means that all FDA-approved contraceptive methods were available at no charge to women enrolled in most private insurance plans. However, the new ruling means that an estimated 70,500-126,400 women of childbearing age will now need to pay out-of-pocket for birth control. Many of the most effective methods are very expensive, the study authors noted. 

The Texas Policy Evaluation Project (TxPEP) uses data from the 2015-2017 National Survey of Family Growth with a focus on sexually active reproductive age women in the United States who were not pregnant nor trying to become pregnant. The study also examined birth control access by race and ethnicity, according to the press release. 

The study authors found that 1 in 5 privately insured women were likely to prefer a different birth control method if cost was not a factor. For publicly insured women, 1 in 4 indicated they would choose a different method. The rate was even higher for uninsured women at 1 in 3. 

Black women face additional barriers to accessing contraceptives, according to the press release. Accessing birth control was also found to be especially challenging for recent and undocumented immigrants.  

"Whether people are able to afford the type of birth control they want to use is a strong indicator of the quality of reproductive healthcare in the US…The Supreme Court's ruling, along with other recent policies that have limited publicly funded services for low-income women, will likely reverse some of the gains in access and affordability we have seen in recent years,” principal investigator of TxPEP and associate professor of Social Work and Sociology at The University of Texas at Austin, Kari White, PhD, MPH, said in the press release.

Some of the most effective contraceptive methods, such as female sterilization and implants, are also the most expensive, according to the press release. 

Reference:
Cost prevents one in five US women from using their preferred contraception (News Release), Austin, TX, July 13, 2020, EurekAlert!, accessed July 15, 2020