Access to Birth Control, Under the Next President

By Amanda Marcotte, RH Reality Check. Posted October 21, 2008.

It's hard to measure support for access to contraception for two reasons -- "access" and "contraception" both denote very broad categories.  Contraception is everything from condoms to birth control pills to sterilization, and access points range from non-profit distribution to convenience stores to doctor's offices.  Do we consider someone's access more or less limited if they can get birth control pills from Planned Parenthood but the condoms at the grocery store are locked up after 10pm, which is when they discover they need them?  I can't answer that question for you, because it's the very definition of subjective, but I can point out five basic areas where access meets contraception and how the two candidates for President approach them.  As far as I know, both McCain and Obama have not registered an opinion on whether or not it's completely lame of your grocery store to require you to summon a clerk to open the condom display.   

So here's a rundown of five basic questions people ask of themselves when looking to access contraception, and answers Senators McCain and Obama have given through votes and campaign platforms. 

Can I get a prescription from a doctor? 

The chance of getting a prescription from a doctor is 99% based on whether or not you can see one, and that, for most people, depends on if you have insurance that covers this.  Currently, 16% of Americans don't have this basic opportunity.  Both candidates claim they have plans that will get coverage to most Americans and lower costs, but these are claims that bear closer examination.   

The McCain proposal is all about the free market.  The campaign claims that getting people out of employer-provided health care and making them free agents on the market will lower prices.  To reach this goal, they intend to tax employer-provided benefits, with the hope that this encourages people to give up that coverage.  Less people using employer-provided benefits is extremely unlikely to have the results promised by McCain.  We only have so many uninsured people right now because they don't have employer-provided insurance, and therefore can't use their employers' bargaining power to get coverage despite pre-existing conditions.  At best, we will see people just paying more for health care under the McCain plan, but at worst we'll see the number of uninsured go up, meaning that more women will have to turn to non-profits or government programs for birth control access.  Or go without.   

The Obama proposal takes another tack, responding to the fact that most Americans who are uninsured are so because they don't have access to employer-provided health care.  People who already have employer-provided health care don't have to change a thing or pay more for it.  People who aren't able to access that kind of health care will be extended the opportunity to buy into a national health plan that will have guaranteed eligibility, so you won't need to have an employer's power backing you up so you can get insurance.  For people who don't already qualify for Medicaid or SCHIP but still need assistance paying for health insurance, there will be subsidies to help them out. 

By addressing the main cause of insurance gaps---lack of access to employer-provided insurance---the Obama plan will be far likelier to increase the number of Americans who have coverage. 

Can I get contraceptives from non-profits or government programs? 

For people who go to Planned Parenthood or some other non-profits that receive government funds for their health care, this election might also influence their bottom line ability to receive care.  The main thing you're wanting to look at in this department is the voting record on Title X and other family planning programs.  On this issue, the two candidates strongly differ.  McCain attempted to end Title X funding that pays for contraception programs, as well as other women's health care.  Obama is a strong supporter of Title X funding, which causes much consternation amongst anti-choicers.  If you get your contraception---prescribed or over the counter at a discount---or any kind of health care from Planned Parenthood, then this is the funding debate that pertains to you.  

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Amanda Marcotte co-writes the popular blog Pandagon. She is the author of It's a Jungle Out There: The Feminist Survival Guide to Politically Inhospitable Environments.

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