Mark Udall and Cory Gardner are in a tight senate race right now, and one of the issues that has come up in several ads is contraception. Here’s what women in Colorado need to know about the two candidates and how their positions would impact our access to contraceptives:
- Udall supports the ACA. One of the strongest consumer-protection aspects of the ACA is the provision relating to contraceptives for women. Under the ACA, the full range of FDA-approved female contraceptives are available with no cost-sharing (ie, the insurer pays the full cost) for all women who have private coverage that they buy on their own or obtain from an employer.
- Colorado Medicaid also covers the full range of FDA-approved contraceptives for women, and they go one step further and also cover vasectomies (the ACA does not require male contraceptive measures to be covered).
- Because Colorado is one of the states that has expanded Medicaid under the ACA (Udall supports Medicaid expansion, Gardner does not), all legally-present residents here now have access to affordable health insurance that covers contraceptives with no cost-sharing. If your household income is less than 138% of poverty (about $31,700 for a family of four), you qualify for Medicaid. If your income is between the Medicaid threshold and 400% of poverty (about $95,400 for a family of four), you qualify for subsidies that limit your premiums to specific percentages that are deemed affordable based on your income. If your income is above 400% of poverty, the retail prices on health insurance plans are considered affordable.
- Gardner supports repealing the ACA. And he does not support Colorado’s expansion of Medicaid.
- At an October 7 Gardner-Udall debate in Denver, Gardner was specifically asked what he would do for the 200,000 Colorado residents who have gained coverage through Medicaid under the ACA if the ACA (which included the provisions for Medicaid expansion) were to be repealed as he has called for. He did not answer the question, but instead turned his response into an attack on Obamacare.
- Gardner’s primary talking point regarding contraceptives has been about making oral contraceptives available over the counter, and claims that he’ll “ensure that women can be reimbursed for those through insurance.”
- Udall also supports making oral contraceptives available OTC, as long as health insurance still pays for them.
- But OTC pills is basically the beginning and the end of Gardner’s “plan” for contraceptives. Udall, on the other hand, supports the ACA. This includes the provision that allows women with private plans access to the full-range of FDA approved contraceptives, and also the expanded Medicaid program in Colorado that provides access to the full range of female contraceptives as well as vasectomies for men – all without cost-sharing for the insureds.
- Regardless of what either politician says, Congress has no say in moving a drug from prescription to OTC. That’s the FDA’s job, and Senators cannot authorize such a change, regardless of campaign promises (so if your only “plan” for contraceptives is to make them OTC, you might be over-promising as a political candidate).
- Although birth control pills are popular, there are other forms of birth control – namely long-acting, reversible contraceptive (LARC) methods that include IUDs and hormonal implants – that are gaining traction now that the up-front cost barrier has been removed. LARC methods are among the most effective, but the up-front cost to obtain an IUD was typically in the $500 to $1000 range prior to the ACA’s contraceptive mandate. Although over the 5 or 10 years that the IUDs remain in place, their monthly cost diminishes to less than a typical oral contraceptive, the up-front cost has long been a barrier to many women.
- Two programs – one here in Colorado and one in St. Louis – recently released the results of their efforts to provide no-cost birth control to teenage girls. Not surprisingly, the teen birth rate dropped considerably among both groups of girls. And when all of the contraceptive options were explained and provided without cost, 72% of the girls in the St. Louis group selected a LARC method. The Colorado project focused entirely on LARC methods.
- LARC methods of contraception are virtually error-proof. Users do not need to remember to take a pill or go to a clinic for a shot. The major drawback to LARCs – cost- was removed thanks to the ACA. Udall supports the ACA and it’s contraceptive mandate. Gardner does not.
