Contraceptive Access in the United States
07.18.13 - The right to obtain and use contraceptives is part of the fundamental right to privacy guaranteed by the United States Constitution. The Supreme Court has stated that this right extends not only to married adults, but also to unmarried persons, including teens. Despite the existence of that right, it is evident that contraception needs in the country are not met:
- Half of the six million pregnancies in the U.S. each year are unintended.
- About one-third of girls get pregnant in the United States before the age of twenty; the vast majority of these pregnancies are unintended.
In addition, the rates of unintended pregnancies are significantly higher for poor women and women of color.
- Funding for the U.S. government's Title X program, which funds low-cost, confidential family planning services, is 61% lower today in constant dollars than it was in 1980.
- Some state governments have enacted refusal clauses (or so-called "conscience clauses") that permit pharmacists and healthcare providers to refuse to dispense medication, including contraception, when the use of it conflicts with the provider's religious or moral beliefs.
- The U.S. government has placed obstacles in the path of minors and immigrants seeking emergency contraception ("EC"), despite the scientific evidence supporting the safety and benefits of easy access.
- Some employers that provide otherwise comprehensive health insurance benefits have refused to provide benefits for certain contraception and related services.
Protecting women's access to contraception is a top priority for the Center. The Center has undertaken a variety of initiatives to make contraception more readily available.
- When EC was available only by prescription in this country, the Center filed a citizen petition with the U.S. Food and Drug Administration on behalf of over 70 medical and public health organizations seeking to make EC available over-the-counter (OTC). In 2005, after years of inaction and political maneuvering by the FDA, under the influence of the White House, the Center filed a lawsuit against the FDA. In 2006, the FDA agreed to permit EC to be available without a prescription, but only to women 18 or older and only behind pharmacy counters. In March of 2009, the court ordered the FDA to approve Plan B for those 17 and older without a prescription and to reconsider the citizen petition and all age and point-of-sale restrictions. In the months that followed, the FDA approved Plan B OTC for those 17 and older, but repeatedly refused to make it available OTC for younger women and remove the other unique point-of-sale restrictions currently in place. Accordingly, in 2012, the Center re-opened our case and challenged the FDA's latest actions, including HHS Secretary Sebelius' overruling of the FDA's plan to allow Plan B One-Step, one brand of EC, to be sold to women of all ages. The Center filed a motion for a preliminary injunction and summary judgment, requesting that the court order immediate and permanent OTC access for all levonorgestrel-based emergency contraceptives without age or other restrictions. On April 5, 2013, the court granted the Center's motion and ordered OTC access for all levonorgestrel-based emergency contraceptives without age or other restrictions within 30 days. The FDA filed an appeal of the court's order, but on June 10, 2013, the FDA reversed course, proposing to comply with the April 5 order by making Plan B One-Step available OTC without age or other restrictions. The FDA has now approved Plan B One-Step available OTC without age or other restrictions, and granted the citizen petition, in what is a major victory for women's access to EC.
- The Center is fighting to expand contraceptive coverage for American women through the implementation of the Affordable Care Act (ACA). Under the ACA, insurance plans must now cover without co-pays a wide range of women's preventative health services, including contraception. Although this is an important victory for women's health, nearly thirty lawsuits have been filed since the Obama Administration first announced the women's preventive services benefit by employers who wish to deny their employees access to contraception through their health plans. In February 2012, the Center published a comprehensive report that examines the facts of the controversy and debunks the opposition's arguments against the benefit. We are dedicated to protecting reproductive rights against dangerous refusal clauses—you can learn more about that work, as well as read our comments to the docket, testimony before Congress, and op-eds on the matter. You can also read more about the benefits offered by the Affordable Care Act and what it means for you.
- The Center was involved in two cases that upheld the constitutionality of "contraceptive equity laws" at the state level, Catholic Charities of Sacramento v. Superior Court of Sacramento and Catholic Charities of the Diocese of Albany, et al. v. Serio.
- The Center supports increased Title X funding in appropriations legislation, which improves access to contraception distributed through community health centers. The Center works to stop anti-choice legislators from destroying Planned Parenthood and other health centers through legislation that guts their programs and denies all funding.
- The Center works to promote state legislation aimed at increasing access to EC through: public education programs; requiring access to EC in emergency rooms for victims of sexual assault; and permitting pharmacists to provide EC to all women who need it (including minors) without a prescription.
If your employer excludes contraception from its health insurance benefits and you are interested in talking to someone about what you can do to change that policy, contact the U.S. Intake Attorney at 917-637-3600 or email us as we may be able to help.