The good news about birth control access

Birth control is both popular and common. But watching politics in the past three years, it would be easy to forget that. Exactly 50 years since the Supreme Court struck down a birth control ban in Griswold v. Connecticut, birth control is still contested. And yet the fact is that so far, the expansion of access to birth control is a massive, if unfinished success, despite the best efforts on the right to thwart it. 

Since the Obama administration announced in 2012 that contraception would have to be fully covered by insurance like other preventive care — just like a blood pressure screening or a flu shot — the long under-the-radar war over women controlling their own fertility has bubbled up to the surface. Even after religious leaders got an exemption for houses of worship and a workaround for religiously affiliated non-profits, contraception opponents went to the Senate seeking broad religious opt-outs. They lost that round, but won at the Supreme Court. And House Republicans have just proposed killing the program that funds contraception for low-income women. 

On Friday, the Obama administration announced its plan to provide contraceptive access to women working at companies whose owners object to covering contraception. It looks a lot like the accommodation that the religious right has sued over in a new round of litigation. The litigants argue that even if they don’t have to financially contribute to the contraceptive coverage, notifying the government or an insurer of their objection is still a religious violation. Such beliefs are premised on the claim that the most effective forms of contraception are actually abortion, in defiance of the scientific evidence. 

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Contraception was supposed to be a relatively neutral common ground on which abortion opponents and feminists could meet. Instead, it’s being subjected to the same poisonous polarization as abortion. And that’s before you get to the paperwork and administrative hassles with insurers who have been found to not be complying with the law. Or the fact that the entire Affordable Care Act has long been in the crosshairs.

It’s even more striking, then, that the pro-birth control camp has managed to accomplish what it has. Just check out what’s happened in the past few months:

• In the first year that all plans had to cover all forms of contraception without any additional cost, women saved literally billions of dollars — an estimated $1.4 billion on the pill alone, not counting the expensive but highly effective methods like the intrauterine device (IUD.) 
• Blue states are using the Obamacare requirements as a floor, not a ceiling. California and Oregon are making it easier to get contraception directly from a pharmacist after a screening. (You’d still need to go to a doctor for an IUD, though, and questions remain about insurance coverage.) New York is considering legislation to expand the coverage requirements to male birth control, including vasectomies, and to make it easier to get a year’s supply of the pill. 
• The Obama administration’s plan to cover women whose employers object to contraception has been approved by every federal court that has seen it so far. (That might change with a few pending cases, which would mean it would return to the Supreme Court.) 
• There’s more proof than ever that contraceptive access works. A pilot program in Colorado gave women who wanted it free long-acting reversible contraception, including IUDs. The result: the teen birthrate was down 40% in four years, the abortion rate down by 42%. Too bad Republican legislators refused to fund the project.  

Of course, even the victories are inflected by political caveats. But that makes the successes all the more remarkable.