by Birthright: A War Story | 3.27.18
If anyone told a young woman today that she was expected to quit school after eighth grade or leave her job once she got married, most Americans would be outraged. Not fair! Women should have the same range of economic choices as men.
Through the years, one door after another has opened, as women have become astronauts and neurosurgeons, run Fortune 500 companies and nonprofit organizations, and started their own businesses. Sure, there’s still a lot of ground to make up, but the country has headed in the direction of greater equality for decades now.
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Despite this progress, near-constant attacks on safe and cost-effective women’s health care have become a regular part of our political debates. The latest front in this battle? Access to contraception. The Affordable Care Act required employer-sponsored health insurance policies to cover birth control without additional costs. On October 6, in one of his series of reckless attacks on health insurance in America, President Trump ended that protection.
These fights are often framed as ideological discussions. But for millions of women, access to health care isn’t about ideology at all—it’s about economics.
Americans, at least in private, agree that using birth control is a no-brainer. The vast majority have used it, including 99 percent of women (and by extension, their partners) who have had sex between the ages of 15 and 44.
Some of the reasons for this are obvious. Contraception prevents unintended pregnancy and reduces the abortion rate. Certain forms of birth control prevent sexually transmitted infections, and others help control debilitating health conditions. But contraception is not only about health; it is about economic security as well.
Americans, at least in private, agree that using birth control is a no-brainer.
As every parent knows, the decision to have children is momentous—and carries massive economic consequences. Because the United States does not ensure that parents have access to paid family leave or affordable child care, new costs add up quickly. The totals are striking: Middle-income parents with two kids will spend an estimated $230,000 to raise a child born in 2015 from birth through age 17, amounting to roughly $13,000 per year. Starting a family is a big commitment, and millions of people use contraception until they decide to do so.
But the out-of-pocket costs for baby cribs and car seats are only the tip of the iceberg. A mother experiences a measurable decline in earnings immediately after having a child—a decline that continues throughout her lifetime. And women don’t have to be mothers to benefit economically from contraception—just ask college students, or women with crippling endometriosis, how contraception helps them land and hold down jobs. The arrival of the birth control pill in 1960, later joined by other effective contraceptives, gave Americans more control over if, when, and how they chose to grow their families. That control, in turn, helped fuel economic opportunity for American women, American families, and the American economy. After the widespread introduction of birth control, the number of women in professions once closed to them increased dramatically. And without the movement of women into the workforce since 1970—a trend partly enabled by the availability of effective birth control—our country’s GDP would only be three quarters of the size it is today.
Contraception helps level the economic playing field for women. With birth control available, women have more chances to go to school, get jobs, create businesses, and grow our economy. They can more reliably plan their economic futures. But birth control offers these benefits only when women can access it—and when their bosses can’t dictate what types of birth control it’s appropriate for them to use.
While 99 percent of women have used birth control at least once, cost is a big factor restricting consistent access. Prior to the ACA, one in three women struggled to afford the out-of-pocket costs of prescription birth control. These costs put additional strain on the finances of workers already struggling to make ends meet—and also reduced contraceptive use. According to a 2010 Centers for Disease Control report, hundreds of thousands of women who tried various forms of contraception gave up because the methods were “too expensive,” “insurance did not cover it,” or because contraception was “too difficult to obtain.” The ACA’s birth control protections helped level the playing field: Women in America saved an average of $255 a year on birth control pills and saw cost reductions for other contraceptive methods.
For millions of women, President Trump’s edict isn’t some abstract, ideological debate. For a working couple with modest wages and piles of student loan debt, the ability to decide when to have children is an economic issue. For a student working toward her college degree and financial independence, access to birth control is an economic issue. For a woman working two jobs with two kids in day care, affordable contraception is an economic issue. This isn’t the Trump administration’s first attack on women’s health. Efforts to defund Planned Parenthood, repeal the ACA and Medicaid, and block access to safe, legal abortions have put women on the economic defensive. But those efforts require Congress—and so far, despite the best efforts of Mitch McConnell and Paul Ryan, they have failed. Now President Trump has turned to a decision he can make without Congress: make it harder to access birth control. With the stroke of a pen, the President shrank the economic futures of millions of women. He should reverse this decision—and if he won’t, Congress should force him to.
Written by Birthright: A War Story
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