TIME Birth Control

Going Off the Pill Could Affect Who You’re Attracted to, Study Finds

New research shows that going off the pill could affect how attracted you are to your mate

Your birth control pill could affect your relationship, and not just because it halts baby-making. A new study published in the Proceedings of the National Academy of Science followed 118 couples who met while the woman was on hormonal birth control and found that going off the pill could impact how attracted she was to her partner.

Whether a woman’s attraction to her mate shifted post-Pill seemed to be determined by how objectively good-looking he was by evolutionary standards, which means his attractiveness is an indicator of genetic fitness. Some women with partners who were not conventionally attractive reported being less attracted to him after stopping oral contraceptives, whereas a decrease was not seen in women whose partners were conventionally handsome.

“Women who choose a partner when they’re on hormonal contraceptives and then stop taking them will prioritize their husband’s attractiveness more than they would if they were still on it,” says Michelle Russell, the Florida State graduate student who is the lead author on the study. “The effect that it would have on her marital satisfaction would carry more weight.” That means that if your husband is not conventionally attractive and you go off the Pill, his attractiveness might bother you more than before. Conversely, if you’re bored of your foxy husband, going off the Pill might make you more excited about him. Maybe.

Russell says the change may be attributed fluctuating estrogen levels, but says there could be many hormonal reasons for this effect. She also doesn’t suggest that this finding should dissuade women from using oral contraceptives. “This is just one finding,” she says.

Other studies have looked at how the Pill affects female attraction. A 2008 paper published in The Proceedings of the Royal Society B found that while women are usually attracted to the scent of men who are genetically different from them, women on the Pill are attracted to the scent of men who are more genetically similar. This may be because the Pill fools your body into thinking it’s pregnant, and pregnancy can affect attraction. In discussing the 2008 study, Scientific American hypothesized that while non-pregnant women would be more attracted to genetically dissimilar men (to avoid the possibility of incest and maximize immunity of their offspring,) women on the Pill may be more drawn to genetically similar men because pregnant women seek out family members.

Another study of 365 couples published this year in Psychological Science found that women who went on or off the Pill during a relationship were less sexually satisfied than women who were consistently on the Pill or who had never been on it.

While the exact mechanisms for how oral contraceptives affect female attraction aren’t totally clear, there is mounting evidence that hormonal birth control can affect more than just fertility. But scientists are not necessarily advocating that the risks outweigh the benefits. “Any drug that you take, people want to be informed consumers,” Russell says. “This is just one factor women might want to consider when deciding whether or not to use them.”

TIME women

Did We Give the Pill Too Much Power?

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Getty Images

Elizabeth Weingarten is the associate editor at New America and the associate director of its Global Gender Parity Initiative.

The answer to why we are still struggling with reproductive rights in this country may have to do with our original—and perhaps unrealistic—expectations of how much the pill could change things in the first place

This pill came with a promise: help extinguish sexism from public life by removing a key roadblock for women. If women could plan when and whether they became pregnant, they should be better able to develop careers and livelihoods, avoid a life of economic dependence on men, and form identities outside of motherhood.

In many ways, the birth control pill kept that promise by enabling women to enter the workforce, improving their health by helping them to space out pregnancies, and allowing them to have sex for pleasure. But more than 50 years after the pill first came to market, its promise of access and equality remains unfulfilled for millions of other women.

Think about the Hobby Lobby decision, which ruled that certain businesses can deny employees coverage for contraception on the basis of religious beliefs. The fact that many insurance plans still don’t cover contraception or infertility treatments. “Time passes and yet we’re still kind of stuck when it comes to reproductive rights,” said New York Times Health reporter Catherine Saint Louis at a recent New America NYC event. Cost and culture still prevent millions of low-income women here and abroad from obtaining the pill.

“The things we’re talking about [today] are the same things [Margaret Sanger, one of the pill’s bankrollers and the founder of Planned Parenthood] was talking about in 1914,” said Jonathan Eig, the author of the book, “The Birth of the Pill.” “I honestly believe she thought once the pill got out there, the genie would be out of the bottle, women would have all the power they needed and everything would be fine after that… I really think she’d be stunned.”

So how did we get here?

At least in part, the answer may lie in the scope of our expectations; we have asked a lot of one medical invention. After all, said Eig, the idea that the role of a woman is to be a vessel for a child is rooted in thousands of years of history. This biological difference is the foundation of gender inequality – the thing that for centuries kept them out of economic and professional competition with men, noted New Republic Senior Editor Rebecca Traister.

That’s a powerful dynamic and hard to reverse. The pill turned into a silver bullet, that single technological innovation that would allow us to avoid confronting the deeper, more impactful social structures that sustain gender discrimination. We can’t ask the pill and its users to fix a problem the rest of us choose to ignore.

Here in the U.S., the pill put “all of the onus and responsibility [of pregnancy] on individual women without a sense of accountability of community and government to support whole and healthy lives,” explained Tiloma Jayasinghe, the executive director of the anti-violence against women organization Sakhi for South Asian Women. But “we’re not in this by ourselves.”

It also sidelined men, taking their responsibility out of the equation and separating them from the reality of reproduction, Traister said. “That’s how you get Rush Limbaugh talking about, ‘how much sex are these women having that they have to pay this amount per pill?’ What it has done is further made reproduction ‘women’s territory’ in certain ways.”

“It was a double-edged sword,” said Eig.

Even when companies clumsily try to give agency to women, it illustrates how much society has put women in an untenable situation. Facebook and Apple announced recently that they would begin offering egg freezing as part of their healthcare benefit plans. Critics accused the tech companies of putting pressure on women to sacrifice life for work, and decried the use of egg freezing as dangerous. But that criticism is misguided, argued Traister. Rather than blame Facebook and Apple, why not fault a “system that repeatedly puts new possibilities on offer and keeps them from people who need them”? Everyone, not just tech companies, should offer these types of benefits because they’re part of women’s health, she said.

Improving women’s health is a major benefit of the pill. Before the pill, birth control was inefficient, inaccessible, and often completely controlled by men. Consequently, women were having more children than they wanted – often faster than their bodies could handle them. In many cases, this led to maternal and infant death, or economic instability and famine.

That’s still the case overseas, where Silver Bullet laziness may also be a factor. Though the pill has led to many health benefits, including a reduction in infant and maternal deaths around the world, its effects have been uneven and limited in certain developing countries. “The WHO and other organizations are promoting the use of the pill to space pregnancies, and yet they are doing so in countries where women don’t always have control of their bodies or access to the pill,” Jayasinghe said. She suggested that the pill’s success may lead to complacency in those regions: “We have it now, our work is done. But it’s not done.”

So how do we change the system here and abroad?

For many countries, harnessing the power of the pill will require a major culture shift. It needs to become okay for mothers to talk to daughters and fathers to talk to sons about contraception, which won’t be an easy fix, Jayasinghe said. (And critically, contraception is much more than just the pill. There are other forms of more reliable contraception – like IUD and hormonal implants – that in some cases are even preferred by women, but may be pricier or harder to access).

Here in the U.S., “we need to broaden our discussions to beyond fighting about abortion to a fuller scope of what do rights mean – the full scope of contraception,” Jayasinghe said. Abortion is just one issue in a women’s life – and making it a nitpicky focal point of reproductive conversations is limiting, she suggested. Ideally, legislators would introduce – and pass – some kind of comprehensive women’s reproductive rights and healthcare bill. That also means recognizing infertility as a real health problem, Saint Louis noted. Right now – in many circles – it’s an “I’m so sorry you waited until you were 35 [to have kids] problem, rather than recognizing that it affects 19-year-olds.”

It’s also critical to include men in conversations – both personal and public – around reproductive issues. Research shows that when men and women are required to take sexual education classes together, for example, birth rates drop dramatically, Eig pointed out. And after all, the scientific mastermind behind the pill was a man – Gregory (Goody) Pincus.

“There’s still a long way to go,” Eig said. “If there were more people like Goody [Pincus] fighting today, we’d see more innovation and more attention still being brought to this cause.”

This piece was originally published in New America’s digital magazine, The Weekly Wonk. Sign up to get it delivered to your inbox each Thursday here, and follow @New America on Twitter.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME reproductive rights

Dear Fellow Conservatives: Want Fewer Abortions? Tolerate Birth Control

Right for a Reason
Right for a Reason

Amy Jo Clark and Miriam Weaver are the authors of Right for a Reason: Life Liberty and a Crapload of Common Sense.

We are pro-life, but we know that science, the law and reason mean we need to support contraception

Remember back in the Clinton years when the goal was to make abortions “safe, legal, and rare”? Over time, pro-choice progressives have shifted the messaging to make abortions as easy, accessible, and convenient as possible. As pro-life conservatives, we want to see as few abortions as possible. We understand and even accept that it’s legal for women to have abortions, but conservatives are right to insist that women be fully educated on what the procedure actually is before they have it. It’s right to believe that legislation requiring a woman to have an ultrasound before aborting her baby is appropriate. It’s right to require women to go through at least minimal counseling about alternatives to abortion before they go through with it. Abortions shouldn’t be easy and convenient. But if our ultimate goal is to drastically reduce the number of abortions that occur every single year, we must exercise some flexibility in our tolerance of contraception (and even emergency contraception). That’s why we support the use of birth control pills and even Plan B.

If you’re a conservative and you’re about to call us RINOs and just dismiss us because we’re not pro-life enough now, just hear us out…. Contraception has become a tricky topic for pro-life folks. Birth control pills, which have been widely used by thousands of women in the United States for decades, are now the subject of hot debate in many religious circles. And when emergency contraception like Plan B is thrown into the conversation, the debate gets even hotter.

Our research into contraception taught us three critical pieces of information: First, only about forty percent of fertilized eggs ever implant into the uterus naturally. Second, in the medical and legal communities, a pregnancy does not begin until a fertilized egg implants into the uterus. Finally, birth control pills (and Plan B) have the primary function of stopping an egg from being released by the ovaries and a secondary function of preventing fertilization of a released egg. The most recent research and studies indicate that neither birth control pills nor Plan B prevent the implantation of a fertilized egg into the uterine wall. And even if they did, they would not be considered abortifacients, because abortifacients, by definition, terminate pregnancies (which, again, do not begin until a fertilized egg implants). Contraception prevents pregnancies. This distinction is important.

The immediate reaction to this by the staunchest of pro-lifers is typically, “But life begins at conception!” We don’t disagree. But in order for that life to develop, a pregnancy must occur as defined above. If you are opposed to all forms of synthetic hormone contraception or IUDs because of the very unlikely possibility that those forms of birth control might prevent a fertilized egg from implanting into the uterus, we congratulate you on your purism, but would also ask you how exactly that purism helps the cause to reduce the number of abortions? If you’re expecting that every American woman is going to limit her contraception method to either condoms or the practice of “natural family planning,” and you also expect that this thinking is somehow going to result in a decrease in abortion, then with all due respect, you are high.

Since pregnancy doesn’t actually begin until a fertilized egg implants into the womb (which, again, happens less than 50 percent of the time naturally), mourning the loss of thousands of unimplanted fertilized eggs seems completely counterproductive considering that thousands of fully formed fetuses with beating hearts are killed via abortion every single day. If your definition of abortion includes every instance of a fertilized egg failing to implant in the uterus, then you’re essentially suggesting that millions of women are murderers without even realizing it. You’re suggesting that birth control pills and IUDs are every bit as immoral as the act we normally think of when we mention the word “abortion.” We think that’s pretty unreasonable.

Women should be responsible enough that if they intend to have sex, and do not want to become pregnant, they should make sure that they are protected. But as realists, we understand that people don’t always make good decisions. Since we don’t live in an ideal world, shouldn’t we exercise some tolerance about contraceptive solutions in order to ensure women don’t get abortions well into their established pregnancies? When faced with the choice of seeing a woman getting Plan B the morning after she has unprotected sex or seeing her abort a baby later in gestation, wouldn’t we all prefer the former? Wouldn’t every pro-life person prefer that?

We must recognize and accept that abortion is legal. There is no indication that this is going to change. Put simply, outrage about abortions won’t stop abortions. And neither will opposition to forms of contraception that, in all likelihood, prevent a huge number of abortions. We believe conservatives should focus on areas where we can make some actual headway on this issue. While we love the idea of simply teaching our kids abstinence and promoting sex within the confines of a committed marriage, that’s not necessarily realistic. We believe that what can realistically help abortions become more rare (which is what all of us want) is balanced encouragement of birth control options and a broader tolerance of emergency contraception, particularly if it will prevent later-term abortions.

Conservatives are right to value and protect life, but we’re also right to avoid damaging our own causes with impossibly unrealistic goals. And we’re right to make strides in this movement in the best, most realistic ways that we possibly can.

 

Amy Jo Clark and Miriam Weaver are the authors of Right for a Reason: Life Liberty and a Crapload of Common Sense. They write the popular Chicks on the Right blog as well as a regular column in The Indianapolis Star, and host a daily drive-time radio show on WIBC in Indianapolis. Clark was previously a medical writer and communications consultant; Weaver previously worked in human resources. They live outside Indianapolis with their husbands and children.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME Research

A Lot of Men Got Vasectomies During the Recession

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Getty Images

Up to an additional 150,000 to 180,000 per year between 2007 and 2009

The recession was accompanied by a sharp increase in the number of American men who underwent vasectomies, according to research presented Monday, though it’s unclear if economic woes actually led to more procedures.

Researchers from Weill Cornell Medical College looked at survey data from the National Survey for Family Growth, which interviewed more than 10,000 men between 2006 and 2010, according to the American Society for Reproductive Medicine. They wanted to get a sense of how the economic downturn from 2007 to 2009 affected men’s decisions about having kids.

Before the recession, 3.9% of men reported having a vasectomy, but 4.4% reported having one afterward, which the researchers calculated to mean an additional 150,000 to 180,000 vasectomies during each year of the recession.

The researchers also found after the recession that men were less likely to be employed full-time, and more likely to have lower incomes and be without health insurance. Nothing changed when it came to men’s desire to have children, but those who were interviewed after the recession were more likely to want fewer children.

It’s important to note that the study, which is being presented at the American Society for Reproductive Medicine’s 70th Annual Meeting, does not prove causation, meaning it’s unclear whether men were undergoing surgery for financial reasons. Though the researchers do conclude that their findings suggest Americans may be factoring economics into family planning—which is not necessarily a new trend.

TIME sexuality

Take a Look at History’s Worst Contraceptives for Women

This video was made to raise awareness of family planning

lost-at-e-minor_logo

This article originally appeared on Lost at E Minor.

While the pill has been around for over 50 years, it took quite a long time to come up with a fuss-free method of contraception. Before the pill’s creation, there were some really awful ways to prevent pregnancy, and non-profit organization EngenderHealth has come up with a video to show us of all those methods. We’re talking crocodile dung mixed with honey, beaver testicles with moonshine, pig intestines, and even glass bottles.

The video was made to raise awareness of family planning through EngenderHealth’s WTFP?! initiative, which aims to give a voice to the more than 220 million women around the world who don’t have access to contraception.

(via Design Taxi)

TIME Sex/Relationships

Doctors Advise IUD Use as Best Birth Control Method for Teenagers

A copper IUD
A copper IUD B. Boissonnet—BSIP/Corbis

A boost for a little-used but widely effective method of contraception

A leading medical group on Monday recommended implantable rods and intrauterine devices (IUDs) as the best form of birth control for teenage girls other than abstinence.

The new guidance from the American Academy of Pediatrics (AAP), published Monday in the group’s Pediatrics journal, touts birth control methods not commonly used in the U.S. despite widespread agreement about their effectiveness. The AAP says pediatricians, who teens consider “a highly trusted source of sexual health information,” should recommend, in decreasing order of effectiveness, progestin implants, IUDs, injectable contraception, and oral contraception for use among adolescents.

(MORE: The best form of birth control is the one nobody is using)

The doctors call oral contraceptives the least effective options for teens because many fail to use them properly and consistently. About 18% of women experience an unintended pregnancy when using male condoms, compared to 0.8% who experience unintended pregnancy while utilizing a Copper T IUD. Though IUDs are expensive at the outset, the AAP says the long-term cost is less than the cost of over-the-counter oral contraceptives.

TIME faith

Missouri Lawmaker Sues for Control of Daughters’ Sexuality

Birth Control Pill
BSIP—UIG/Getty Images

Adult women should be allowed to make their own reproductive choices

PatheosLogo_Blue

 

This article originally appeared on Patheos.

Did you see this one coming? (From MSNBC)

One Missouri lawmaker has taken the fight against birth control coverage to a new and very personal place: His own daughters, two of whom are adults.

State Rep. Paul Joseph Wieland and his wife Teresa are suing the Obama administration over its minimum coverage requirements for health plans under the Affordable Care Act, which includes contraception. They say the government is forcing them to violate their religious beliefs because they have three daughters, ages 13, 18 and 19, who are on their parents’ plan and might get birth control at no additional cost.

Wieland’s lawyer makes this comparison:

[Attorney Timothy] Belz also said that making birth control more accessible under health plans was “as though the federal government had passed an edict that said that parents must provide a stocked unlocked liquor cabinet in their house whenever they’re away for their minor and adult daughters to use, and Mormons came in and objected to that. It is exactly the same situation.”

Except that that’s not how insurance works. No one is requiring Wieland to hand his daughters birth control, or to keep a stock of birth control on the kitchen table for easy access. What the law says is simply this: health insurance companies must cover birth control with no deductible or copay. That’s it. Yes, Wieland has his daughters’ on his health insurance plan. His wife is on it too, so she, too, has access to birth control as well. It’s about ensuring that insurance companies cover women’s healthcare, period.

Look, health insurance companies cover blood transfusions. I suspect they’re required to by law, too. Could a Jehovah’s Witness parent object, because his adult son might get a blood transfusion should he ever be in need of one? Applying Wieland’s logic leads to a mess. I mean by his logic, parents should be able to pick and choose through their children’s health insurance and pick and choose which things their children can have covered, provided they can make a religious justification and completely irregardless of their adult children’s religious beliefs.

Now of course, the fact that Wieland’s daughters can get birth control on their parents’ plan doesn’t mean they have to get birth control. And if they share their parents beliefs on the subject, they won’t. But Wieland is concerned that they might not share his beliefs.

One of the judges pointed out that parents might have more control over their kids than employers, and that parents could just say to their kids, “We expect you do abide by our religious tenets.” Belz replied, “Well, we all have high hopes for our kids, that is true. We all expect and want them to obey us, they don’t always …”

These girls are 18 and 19. They’re not children, they’re adults.

There are two ways to look at this. We could say that Wieland is trying to prevent his adult daughters from having access to affordable birth control, and we would be correct. But Wieland’s legal claim is slightly different. Wieland says that paying for his daughters birth control would violate his religious beliefs. In other words, he says this is about his beliefs and his conscience, not about whether or not his daughters are using birth control. But again, this isn’t how insurance works. It wasn’t in the Hobby Lobby case, and it isn’t here. Unfortunately, Hobby Lobby won its case, suggesting that the Supreme Court thinks this is the way insurance works.

Now, Wieland could simply drop his daughters from his plan, and maybe we should be grateful for them that he’s not going that route. Wieland is arguing that his religion requires him to provide birth control for his daughters. The problem is that he’s using this argument to prove that the law requiring birth control coverage violates his religious beliefs.

The Wielands have argued in their brief that providing health coverage to their daughters – which, thanks to the same Affordable Care Act, they can do until their children turn 26 – is also part of their religious beliefs. “The Plaintiffs cannot terminate their daughters’ health insurance coverage without violating their religious duty to provide for the health and well being of their children,” they wrote in one brief.

I think it’s awesome that Wieland believes he should continue to pay for his daughters’ health and well being through providing them with birth control. It would be even more awesome if that belief extended to all of women’s health care. The problem is Wieland’s view of birth control. You would think that a parent in his shoes might want his daughters to abstain from premarital sex, but also want them to have access to birth control should they decide to have sex anyway (after all, a parent cannot prevent an adult daughter from having sex). But no.

Christians who oppose sex before marriage tend to feel that access to birth control increases the likelihood that young people will have sex. This is probably not all that true for young people who are already taught that sex before marriage is sinful. After all, if you belief something is sinful and may send you to hell, whether or not you are protected against STDs or pregnancy is the less important worry. Christians who oppose sex before marriage also tend to believe that having unprotected sex is less sinful than having protected sex. This is because using birth control shows that the sex is premeditated. You can see this last point illustrated in this short video clip:

Wieland is Catholic, which adds another dimension. The Catholic Church teaches that birth control is unacceptable for even married couples. Families may use natural family planning to space their children out—provided they go about it with the right attitude of openness to children—but that’s it. So for Wieland, this isn’t just about his adult daughters having premarital sex, it’s about them using birth control at all. Of course, they’ll have to leave their father’s insurance when they marry, so Wieland won’t have any say regarding their use of birth control in marriage.

I have no idea what Wieland’s daughters think of all of this. They may be completely involved and invested, as I would have been at their age. I would have seen it as a way to fight back against the big bad government in favor of our religious beliefs. But at 21 I would have seen it differently. At 21 I would have felt used, and I would have wanted out. Frankly, I probably would have gotten off my parents’ plan entirely and found a way to make a go of it on my own, were I in their shoes. After all, that’s what I did when it came to paying for college. I didn’t want anything else they could use to control me and my choices.

When it comes down to it, Wieland wants the right to use his daughters’ insurance coverage to control their sexuality. He wants to have a say over whether the insurance he obtains for his family gives his adult daughters’ access to birth control. In a world where patriarchy reigns supreme, this request would be reasonable. But we don’t live in that world. We live in a world where adult women are allowed to make their own reproductive choices (or at least, that is the world we should live in).

Libby Anne was raised in an evangelical family, was homeschooled and was taught that a woman’s place is in the home. She became a non-believer after college and now writes on purity culture, Christian right politics, and the importance of feminism.

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TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME 2014 Election

Republicans Can’t Stop Talking About Over-the-Counter Birth Control

Thom Tillis
Republican senatorial candidate Thom Tillis speaks during a live televised debate at UNC-TV studios in Research Triangle Park, N.C., Monday, April 28, 2014. AP

Republicans may have found an answer to the Democratic “War on Women” battle cry in the most unexpected place: The women’s health section of your local pharmacy.

GOP candidates across the country are calling for birth control pills to be available over-the-counter without a prescription, elevating a once obscure conservative proposal to reduce women’s dependence on health insurance programs. Four GOP Senate candidates have advocated for over-the-counter birth control, Colorado’s Cory Gardner, Thom Tillis in North Carolina, Ed Gillespie in Virginia, and Mike McFadden in Minnesota. “I actually agree with the American Medical Association that we should make contraception more widely available. I think over-the-counter oral contraception should be available without prescription,” Tillis said last week in his first debate against Sen. Kay Hagan.

Liberal groups, not wanting the GOP storyline to take hold, have come back swinging, accusing Republicans of engaging in a deception to fool women. On Monday, Democratic groups in Colorado launched a five-figure television ad campaign to push back on Gardner’s embrace in a television ad last week of the policy proposal, arguing that the plan could raise out-of-pocket costs for women, since insurers who now provide no-cost contraception tend not to cover over-the-counter medication.

The controversy has put Democratic candidates in the odd position of seemingly opposing a policy proposal that voters are inclined to believe they support: the availability of birth control without a doctor’s prescription. From Colorado to North Carolina, Democrats have rejected the proposal as a distraction, contending that it amounts to a clever way of undermining the new benefits provided under Obamacare.

A spokesperson for Democrat Kay Hagan of North Carolina did not respond to a request to clarify whether she would support the over-the-counter proposal, while a spokesman for Mark Udall of Colorado and official with Planned Parenthood Action Fund said they would only consider the issue as long as it is coupled with maintaining insurance mandate. In Colorado, MoveOn and NARAL Pro-Choice America released a five-figure television buy against Gardner on the issue Monday.

Democrats and Republicans trace the political origins of the proposal, which has been pushed by doctors since at least 2012, to Louisiana Gov. Bobby Jindal. In a December 2012 Wall Street Journal op-ed, the 2016 presidential hopeful and former Assistant Secretary of Health and Human Services argued that contraceptives should be made available over the counter to increase access and bring down costs. “As an unapologetic pro-life Republican, I also believe that every adult (18 years old and over) who wants contraception should be able to purchase it,” Jindal wrote, calling for “the end of birth-control politics.”

Because it would be sold over the counter, Jindal argued that prices would be lower because of additional competition, while removing a doctor from the equation would make it easier for women to access it.

It was a shrewd policy proposal designed to provide Republican candidates a safety zone on the thorny subject of contraception. Most Republican candidates have objected to the contraception mandate in the Affordable Care Act which requires most employers’ health insurance to cover birth control despite their religious beliefs. Republicans generally celebrated the Supreme Court ruling in June in the Hobby Lobby case that closely-held companies with religious objects could abstain from covering contraceptives.

Jindal’s political aides, and many GOP operatives, believe birth control is a gateway issue for women voters. While the politics of abortion have remained consistently split, Republicans fear being cast as anti-birth control could cost them a generation of women voters. “It’s often an immediate shutdown,” said one Jindal aide.

But the simple proposal is hardly comprehensive, and is a long way from going into effect anyway. No birth control manufacturer has applied for an over-the-counter designation from the Food and Drug Administration, and only the contraceptive pill would be covered. If private plans didn’t cover other forms of birth control, like IUDs, patients who use them would be forced to spend more out of pocket.

“If Cory Gardner and others were serious about expanding access to birth control, they wouldn’t be trying to repeal the no-copay birth control benefit, reduce Title X funding for birth control, or cut women off from Planned Parenthood’s preventive health services,” said Dawn Laguens the executive vice president of Planned Parenthood Action Fund in a statement. “This is simply a cynical political attempt to whitewash his terrible record and agenda for women’s health. The reality is that Cory Gardner’s proposal would actually cost women more by forcing them to pay out of pocket for the birth control that they are getting now at no cost thanks to the ACA.”

But other Democrats see the GOP strategy as playing right into their hand, with Republicans implicitly acknowledging that women have reason to be skeptical of their agenda. As another Democratic operative put it, “The more time that we spend talking about birth control, we’re winning.”

TIME Innovation

Five Best Ideas of the Day: August 27

1. A reimagined NATO – with rapid response capability – could balance the Putin doctrine.

By David Francis in Foreign Policy

2. Hold the bucket: Focusing on a single disease isn’t a good use of philanthropy dollars.

By Felix Salmon in Slate

3. The Navy’s audacious plan for a new warfighting vessel was too good to be true. The result is a ship that meets none of our needs well. Cancel the Littoral Combat Ship.

By William D. Hartung and Jacob Marx at the Center for International Policy

4. The conventional wisdom is that social media stimulates debate, but self-censorship online actually leads to a ‘spiral of silence.’

By Keith Hampton, Lee Rainie, Weixu Lu, Maria Dwyer, Inyoung Shin and Kristen Purcell at the Pew Research Internet Project

5. Better living through design: Injectable, long-acting birth control will revolutionize family planning in the developing world.

By Heather Hansman in Pacific Standard

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

MONEY Health Care

How Some Insurers Still Avoid Covering Contraception

Locked up birth control pills
Nicholas Eveleigh—Getty Images

Under health reform, your birth control should be fully paid for by insurance. But even before the Supreme Court gave more employers an out, some insurers have been pushing back.

How much leeway do employers and insurers have in deciding whether they’ll cover contraceptives without charge and in determining which methods make the cut?

Not much, as it turns out, but that hasn’t stopped some from trying.

Kaiser Health News readers still write in regularly describing battles they’re waging to get the birth control coverage they’re entitled to.

In one of those messages recently, a woman said her insurer denied free coverage for the NuvaRing. This small plastic device, which is inserted into the vagina, works for three weeks at a time by releasing hormones similar to those used by birth control pills. She said her insurer told her she would be responsible for her contraceptive expenses unless she chooses an oral generic birth control pill. The NuvaRing costs between $15 and $80 a month, according to Planned Parenthood.

Under the health law, health plans have to cover the full range of FDA-approved birth control methods without any cost sharing by women, unless the plan falls into a limited number of categories that are excluded, either because it’s grandfathered under the law or it’s for is a religious employer or house of worship. Following the recent Supreme Court decision in the Hobby Lobby case, some private employers that have religious objections to providing birth control coverage as a free preventive benefit will also be excused from the requirement.

In addition, the federal government has given plans some flexibility by allowing them to use “reasonable medical management techniques” to keep their costs under control. So if there is both a generic and a brand-name version of a birth-control pill available, for example, a plan could decide to cover only the generic version without cost to the patient.

As for the NuvaRing, even though they may use the same hormones, the pill and the ring are different methods of birth control. As an official from the federal Department of Health and Human Services said in an email, “The pill, the ring and the patch are different types of hormonal methods … It is not permissible to cover only the pill, but not the ring or the patch.”

Guidance from the federal government clearly states that the full range of FDA-approved methods of birth control must be covered as a preventive benefit without cost sharing. That includes birth control pills, the ring or patch, intrauterine devices and sterilization, among others.

But despite federal guidance, “we’ve seen this happen, plenty,” says Adam Sonfield, a senior public policy associate at the Guttmacher Institute, a reproductive health research and education organization. “Clearly insurance companies think things are ambiguous enough that they can get away with it.”

If you are denied coverage, your defense is to appeal the decision, and get your state insurance department involved.

“The state has the right and responsibility to enforce this law,” says Sonfield.

Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.

More on the Affordable Care Act and contraception coverage:

 

 

 

 

 

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