Everyone has a defining memory that shapes how they come to see the world. For me, a Gen Z born in 2007, it was kneeling in front of the television, eyes fixed on the screen, watching Barack Obama take the oath of office.
However, more than a decade after the Affordable Care Act (ACA) promised access to birth control, I found myself at the pharmacy counter, forced to walk away without it. My insurance refused to cover the pills I need to regulate my hormones, to prevent a third surgery for cystic breasts, and to alleviate excruciating period pain. That was my first confrontation with a false promise—but hardly the first loss of what I considered a secure right.
In theory, the ACA requires most health insurance plans to cover all FDA-approved contraceptive methods without any cost-sharing. In reality, that promise breaks down at the pharmacy counter—whether on account of delays, rejections, cost-sharing and a host of exceptions. In addition, states are eagerly stepping in to empower pharmacists to decide who does not get contraception.











