USUALLY, when I hear the word “progress,” I picture a line steadily sloping upward.
When it comes to progress in the area of reproductive rights, though, my mental image doesn’t hold; here, the line moves in peaks, plateaus, and dives. Below, we’ll consider why this might be the case and look at the state of access to contraception, abortion services, and comprehensive sex education in 2015.
Access to Contraception
When the Affordable Care Act (ACA) was passed in 2010, it advanced reproductive rights in the U.S. by including a provision that insurers must offer birth control as a preventive service for women without out-of-pocket costs. Specifically, the provision states that insurers must cover all FDA-approved birth control methods, including the cost of services related to birth control, such as counseling and necessary follow-ups.
While many women today now have greater access to birth control thanks to the ACA, some are still facing obstacles. A study by the National Women’s Law Center found that several insurers throughout the country are in violation of the ACA’s preventive care provision. The study looked at the policies of several insurance providers in 15 states, and found a number of infractions, including:
- Many insurers aren’t covering all FDA-approved methods free of out-of-pocket costs, a problem because some women can only use certain forms of birth control;
- Some providers are failing to cover birth control-related services, such as counseling, follow-ups, and implantation, without out-of-pocket costs;
- Some insurers are placing age limits on services.
Check out the study for more information, including itemized infractions.
Women who are incurring out-of-pocket costs for their birth control can contact the CoverHer hotline, a free service for women. Operators can help women determine if their insurance plans are out of compliance with the ACA and guide them through the process of filing appeals and complaints.
Access to Abortion
The Roe v. Wade court decision that protected women’s rights to abortion in all states is 43 years old, but access to safe abortion services has never been a done deal in the U.S., and we have seen several set-backs in 2015. The National Women’s Law Center issued a report in July giving a breakdown of barriers to abortion access imposed by various states, noting 52 new restrictions so far this year alone. A summary of their findings:
- West Virginia and Wisconsin have joined 11 other states in banning abortion past the 20-week mark, allowing only very narrow exceptions;
- Kansas and Oklahoma passed a ban on the form of abortion used in nearly all second-trimester abortions;
- Four states in 2015 have joined 20 others in passing unnecessary regulations on abortion providers. Arizona now requires providers to obtain hospital admitting privileges; Arkansas requires providers of medication abortions to enter into signed contract with a second physician who agrees to handle any complications; Indiana and Tennessee require abortion providers to meet the licensure requirements of ambulatory surgical centers (in Indiana, this regulation applies even to providers of medication abortion exclusively);
- In half of states in the U.S., women cannot receive health insurance coverage for abortions. Arizona joined those ranks in 2015;
- Arkansas joined three other states in passing a law requiring providers to use a less effective, less safe form of medication abortion than the best evidence-based method;
- This year Arkansas and Idaho joined 16 other states in banning medication abortion via telemedicine. Telemedicine increases access to abortion for women in areas without abortion providers, and has been found to be as safe and effective as in-person services.
For more details on these and other barriers to accessing abortion services, see the National Women’s Law Center’s report.
Access to Sex Education
Toward the end of 2014, the American Public Health Association (APHA) expressed a high level of concern over the state of sex education in the U.S., calling on Congress and states to dramatically change the way sex education is funded and implemented. The APHA is calling for comprehensive sex education, which includes information about contraception as well as sexual orientation, gender, power, respect, decision-making, and other important components of healthy sexuality.
A surprising number of states don’t mandate sex education whatsoever, and those that do often allow for methods that have been proven ineffective, such as abstinence-only education. Despite the fact that abstinence-only education withholds important information from young people concerning STI and pregnancy prevention, the federal government continues to fund such programs. Take a look at the following facts, reported on August 1, 2015 by the Guttmacher Institute:
- Only 22 states and D.C. mandate sex education;
- 33 states and D.C. require HIV education;
- Only 13 states require information to be medically accurate;
- 35 states plus D.C. allow parents to opt their children out of sex education (if such is provided);
- Only 18 states and D.C. require that contraception be covered;
- 25 states require that abstinence be stressed if sex education is offered;
- 19 states require sex educators to stress the importance of waiting until marriage.
For more details on the state of sex education today and the research in support of comprehensive sex education, see the APHA’s full report.
Insurance providers are violating the Affordable Care Act, making it harder for women to obtain contraception. Fifty-two new restrictions have been placed on abortion access this year alone. Young people across the country are not guaranteed thorough and accurate sex education.
TL;DR? Reproductive rights still have a long way to go.