What Happens To Birth Control Costs Under The AHCA

Women were understandably concerned about the fate of their health care when the American Health Care Act passed in the House of Representatives earlier this month. There are already a lot of questions, like what it means if the Affordable Care Act's pre-existing conditions protections are rolled back, and whether certain things, like birth control, will cost more under AHCA. Of course, it all really depends.

The AHCA, or the version that passed in the House at least, doesn't get rid of the ACA's requirements for "no-cost" health care services, which means that free birth control is technically safe. But the AHCA could jeopardize the cost of birth control in a few other ways.

The main thing to worry about if you have private insurance and the AHCA eventually passes is that it cuts off state's funding for Medicaid reimbursements, which means that lower income women might find themselves without access to care or birth control. Those cuts would also effectively "defund" Planned Parenthood, which means less access and possibly higher out of pocket costs for the 579,000 women who get birth control there every year.

The AHCA also gives a lot of power to states to decide what a pre-existing condition really is or what they can require insurance companies to cover. For-profit companies already have a lot of freedom under Hobby Lobby to decide whether or not they will cover birth control. This could expand that power.

But, in reality, the AHCA does keep some of the Obamacare protections for key preventative services, like free birth control, STI and HIV screenings, well-woman visits, prenatal care, breastfeeding support and supplies, and screening for domestic violence. So the cost of your birth control might still be free if you have private insurance. But if you have private insurance paired with some pre-existing condition that's no longer protected under AHCA, your insurance premium might go up anyway. So birth control might still be free, but you'll have to pay more if you have private insurance if you've ever had a C-section or been diagnosed with depression — effectively cancelling out the otherwise "free" factor.

Adam Sonfield, senior policy manager at the reproductive health research organization the Guttmacher Institute, told Vox in a statement:

This bill does all sorts of absolutely awful things for health care generally, and for reproductive health care specifically — but this isn’t one of them. This bill doesn't touch the birth control benefit for private insurance.

Don't worry, this isn't The Twilight Zone. Republicans didn't exactly keep the preventative services protections out of the kindness of their own hearts. As you probably figured, GOP leaders either oppose free birth control on moral grounds, or they're fiscally conservative and just dislike any regulation at all.

But they also had to deal with a budget rule called reconciliation to get AHCA passed. That just means they could've rolled back some of the ACA's provisions with a majority vote, or get rid of all of them and have to face a 60-vote majority that Republicans would likely lose. They obviously chose the former. So you can thank random congressional rules for your free IUD.

In short, if you're mad about AHCA, stay mad for sure. But know where to focus your energies, like tackling Medicaid funding or coverage for pre-existing conditions. No-cost birth control is safe. For now, at least.