As if the overturning of Roe v. Wade, and the ensuing introduction of total abortion bans in 14 states, isn’t dystopian enough, the United States has become a country where there isn’t enough congressional support for contraception in order to pass a bill protecting the right of patients to use it and the right of providers to prescribe it. This should horrify everyone, regardless of their sex, gender, age, race, socioeconomic status or any other demographic indicator.
In June, the Senate voted down a cloture motion on the Right to Contraception Act, which would have advanced the bill to the Senate floor. The motion failed to get the 60 votes needed (51–39); the only Republicans to support it were Susan Collins of Maine and Lisa Murkowski of Alaska.
There was nothing in this bill that should have prevented every single senator from voting in favor. After all, 99 percent of American women who’ve had sex with a man have used contraception, and this suite of miracle drugs is also used to treat endometriosis, polycystic ovarian syndrome, cramps, acne, migraines and more.
Congress isn’t the only governing entity, however, that seems disinclined to leave bodily autonomy to the occupants of said bodies.
In fact, the Right to Contraception Act was introduced as a response to comments Supreme Court Justice Clarence Thomas made in his concurring opinion to overturn Roe—he audaciously questioned whether the decision that legalized birth control in 1965 should be reconsidered. (The House of Representatives passed the original version of the Right to Contraception Act a week after it was introduced, in July 2022. The original Senate version never made it out of committee.)
Again, in case it’s not wildly apparent, this is horrifying.
And then there’s the Republican presidential candidate Donald Trump, who, when asked by a Pittsburgh TV host in May, “Do you support any restrictions on a person’s right to contraception?” responded, “Well we’re looking at that, and I’m going to have a policy on that very shortly, and I think it’s something that you’ll find interesting … it’s another issue that’s very interesting but … you will, ah, you will find it I think very smart … I think it’s a smart decision. But we’ll be releasing it very soon.”
Okayyyyyyyy.
Oh, also, Project 2025 proposes restoring the Trump-era religious and “moral” exemptions to the contraceptive mandate of the Affordable Care Act (ACA), allowing healthcare providers to refuse to prescribe or distribute contraception to patients on the grounds that they personally don’t approve of it. The alarming guiding document for conservatives also calls for removing emergency contraception and male condoms from the preventive services covered under the ACA.
Elected officials who say they are against abortion should want to champion bills protecting and expanding access to free, comprehensive contraceptive services—right? The fact that they do the opposite tells us that these politicians care more about controlling women than preventing unintended pregnancies, which, as we all know, is the best way to prevent abortions.
All of these regressive reproductive rights assaults are coming in the context of a decade of stagnant funding for Title X, the domestic family planning program for low-income Americans. Title X is what allows family planning clinics to charge patients on a sliding scale when they can’t afford the full cost of contraceptive and other reproductive health services. Clinics receive annual grants of set amounts from the Department of Health and Human Services, and that’s what they have available for subsidizing patient services, regardless of whether it’s enough to last the year. (It’s never enough.) The amount needed to account for the population growth and inflation of the past decade is $737 million—2.5 times more than the $286.5 million the program has received for 10 years running.
Meanwhile, at the international level, there is a $5.5 billion funding gap for providing voluntary family planning to the 218 million women in low- and middle-income countries who have an expressed unmet need for modern contraception.
The U.S. portion of the current amount spent on contraceptive care globally (which totals $7.1 billion from all sources including national governments and international donors) is only $607.5 million—just over a third of what we pledged to invest while at the landmark UN International Conference on Population and Development in 1994. According to our commitment at that time, our contribution today should be $1.74 billion. U.S. funding has never come close to our pledged share—and to make matters worse—has been stagnant for 14 years. As with Title X, no adjustments have been made during that time for population growth or inflation.
The one recent improvement to contraceptive access was the FDA approval earlier this year of the first over-the-counter birth control pill in the U.S. Opill is available at pharmacies without prescription, but because it’s not a prescription drug, it’s not covered by insurance without a copay. There are efforts underway to help Opill join the ranks of “free” contraceptives, but for the time being, it costs $19.99 per month (with savings for purchasing three or six packs at a time). This, of course, is out of financial reach of many Americans.
Who we support in the upcoming election, at every level of government, will weigh heavily in the contraceptive landscape we will experience in the next several years.
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