Everyone is talking about affordability right now, mainly because of skyrocketing gas, grocery, and housing prices. But I’ve noticed this discourse lacks any mention of an essential expense millions of Americans rely on: birth control.
As attacks on birth control ramp up in the states, it’s essential we understand how these attacks not only take away our reproductive rights and freedoms, but also our economic security. Here are five reasons birth control is an affordability issue.
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- Contraception allows people to have control over their economic security.
Deciding if or when to have a child can be one of the biggest financial decisions a person makes. Studies show that access to birth control is clearly linked to higher participation in the workforce, greater earnings and economic independence for women. People who can control deciding if or when they want to have children are better able to maintain their financial well-being, job security, and the ability to go to work and school.
- Birth control can be expensive.
Birth control can cost hundreds of dollars per year or more. A 2024 study found that the annual cost of birth control ranges from $0 to more than $2,400, depending on the method. Permanent forms of contraception, such as tubal ligation, can cost anywhere from $2,000 to $10,000. Given that 37% of adults are unable to cover a $400 emergency expense, these costs make it harder for many people to afford birth control, especially without insurance coverage.
Of course, federal law requires most health plans to cover contraception without cost-sharing, but that doesn’t always happen (see #5 to learn more).
- Over-the-counter birth control pill is available, but not necessarily affordable.
In 2024, “Opill” became the first daily birth control pill offered for sale on store shelves without a prescription, but most people still need an Opill prescription to have it covered by insurance. Few states require health plans to cover over-the-counter birth control, such as emergency contraception and condoms, without a prescription or cost sharing. The cost of Opill can make it unaffordable for people, especially as the cost-of-living rises.
- Pronatalist attacks on birth control are deepening the affordability crisis.
The pronatalist movement wants to restrict birth control access, even though many people choose not to have kids because they can’t afford to. Rather than supporting efforts that would help people raise families, pronatalists are cutting basic needs programs, enforcing so-called “traditional” family structures, and peddling eugenics and other harmful ideologies. These efforts do nothing to help people make ends meet–and actively harm the communities that already struggle with the rising cost of living.
- Federal law guarantees affordable birth control, but problems remain.
The Affordable Care Act requires most health plans to cover FDA-approved contraceptive methods without cost-sharing. That has been a gamechanger in accessing birth control and keeping it affordable. Even small amounts of cost-sharing (like co-pays and deductibles) reduce the use of preventive services and prescription drugs, especially for low-income people. But some plans violate this requirement and wrongly charge people.
States can also help close the gap. Virginia’s new Contraceptive Equity Act requires health insurance companies to cover FDA-approved contraceptives or their therapeutic equivalents without cost-sharing.
The Virginia law actually goes beyond what the ACA requires. For example, while federal law requires insurers to cover over-the-counter birth control only with a prescription, Virginia’s new law requires insurance coverage of Opill, Plan B, condoms and other over-the-counter contraceptives without the need for a prescription.
States have also investigated and ultimately fined health plans for wrongly charging consumers for birth control. Insurance plans have since agreed to reimburse patients for these charges and establish accountability measures, like staff training and audits.
Despite the Trump Administration’s failure to support people’s basic needs and the devastating policies taking these benefits away from individuals, states can take meaningful steps to ensure that birth control is affordable for their residents.
- Contraception allows people to have control over their economic security.
Birth control should be affordable and accessible, regardless of your income, insurance plan or where you live. When we talk about addressing the affordability crisis, we must recognize that affordable birth control can play a critical role in the discussion. The ability to decide if and when to have children isn’t just a matter of personal freedom, it’s often a cornerstone of economic security.
If you’re still paying out-of-pocket for your birth control and other women’s preventive health care, reach out to us through our CoverHer page so we can help.
The post Five Reasons Birth Control is an Affordability Issue appeared first on National Women's Law Center.
