Issue: Birth Control Insurance Coverage


For Jacqie Greacen, getting access to birth control medications means jumping through hoops and much frustration.

Greacen, a registered nurse at St. Joseph’s Hospital Health Center in Syracuse, relies on birth control medications to regulate her periods and to reduce the pain during her cycles. But the process to get the medication can be tiresome, she said.

“The doctor has to sign-off on it,” Greacen said, “and assure the insurance company that it’s being used for medical reasons and not as a form of birth control.”

If there is any reason to suspect otherwise, the insurance company can refuse to pay for it and, Greacen said, she would be left to foot the bill.

Greacen is among the millions of women for whom access to medications that can be used for birth control is a major health insurance issue. For them, the issue remains caught in economic, religious and political controversy.

Birth control has a long history of controversy. In 1914, for example, activist Margaret Sanger was jailed for providing family planning services. Most recently, the Obama administration re-ignited the debate with a requirement for all employers — including religious institutions — to cover the cost of birth control and family planning in employers’ health insurance without a co-pay from the patient.

In a compromise with religious institutions, the Obama administration changed its policy and is continuing to exempt those employers from the requirement. That also lets stand New York’s law, which already allowed religious institutions to avoid a state requirement for insurers to provide family planning coverage.

Some statistics on contraception and family planning:

  • Most women in the U.S. receive health insurance coverage through private plans. And 85 percent of large employers cover prescription contraceptives in their health plans, according to a Kaiser Family Foundation 2010 survey of employers.
  • New York is one of the 32 states that cover all forms of prescription contraception as a family planning service in its Medicaid  insurance program for the poor.  Those prescriptions include oral contraceptives, IUDs, implants, injectable contraceptives and diaphragms.
  •  In Syracuse, about 5,000 to 6,000 women get contraceptive coverage through Medicaid, according to the Onondaga CountyHealth Department.
  • The cost of birth control such as the pill can be anywhere from $5 to $75 each month, according to Planned Parenthood.  Other forms of birth control such as IUD’s, the hormone shot Depo-Provera or vaginal rings can range from $200 to $1,000 annually.
  • The so-called morning-after pill can cost from $10 to $70 and abortions in the first trimester can run anywhere from $300 to $950, according to Planned Parenthood.

Many women don’t use or don’t have access to birth control because of lack of education and lack of access, said Jean Reilly, director of Onondaga County Health Department. And some women are caught in an income bind. Some women, said Reilly, make too much money to qualify for Medicaid but cannot afford a $50 per month copay for contraception.

Erin Grant, director of marketing and communications at Planned Parenthood of Rochester/Syracuse, agrees that education and access are two of the main reasons why women have trouble obtaining birth control. But, Grant said, the new mandate to get rid of co-pays could help.

“By eliminating the co-pay for birth control, millions of women will have access to the contraceptive method appropriate for them,” she said. “As access to contraception increases, the expenses associated with unintended pregnancies decrease.”

But Danielle Cummings, director of communications of the Roman Catholic Diocese of Syracuse, disputes that the Obama administration’s change in policy solves the concerns of religious institutions.  The diocese has been vocal about its distaste for the new plan and has focused on the premise that contraception coverage is not a women’s rights issue but a religious freedom issue.

As originally written, Cummings said,  “This law will force our religious institutions to do something against our moral views.” She added, “And if something like this can change, where do you go from here?”

Nina Walters, coordinator of Syracuse Catholic Women’s Conference, agrees.  She is disheartened to hear about what’s going on in Washington D.C., she said.  “We are angry not just because we oppose the mandate,” she said, “but because of the fact that the government or an executive mandate could supersede religion and religious freedom.”

For Walters, taking the pill is far from women’s freedom. She doesn’t see it as a positive prevention at all, but as something that does more harm than good, she said. “It’s been known to cause breast cancer, blood clots, and to me that’s not freedom,” she said. “Freedom is the feeling of having nothing in my body and it’s wonderful to feel that way,”

Freedom for registered nurse Jacqie Greacen of St. Joseph’s Hospital means an entirely different thing.

As an employee of a Catholic institution, Greacen said, she is forced to abide by religious rules that mean nothing to her.  “I think it’s terrible and I think it’s a violation of what I believe in,” she said. “Why should I have to abide by these rules when I’m not even Catholic”

She added: “If I want to take birth control to prevent heavy periods then I should be able to do that. And if I want to take birth control because I don’t want to have a child then I should be able to do that too.” Said Greacen: “Why should my institution prevent me from that?  It should be my own choice.”

(Sistina Giordano is a graduate student majoring in magazine, newspaper and online journalism.)


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