A woman’s ability to raise a healthy, financially secure family can hinge on her ability to delay pregnancy while she gets an education and a start in the working world. That’s why 99 percent of American women of childbearing age who have ever had sex with a man have used birth control.

Where women in the U.S. diverge, though, is in their access to contraception – especially the safest and most effective methods. But it can cost hundreds of dollars for a woman to get long-acting reversible birth control, putting it out of reach of low-income women.

That could change if state lawmakers approve a proposal to expand MaineCare coverage of birth control and other preventive health care services. A similar bill passed the Legislature last year but was vetoed by Gov. LePage. Legislators have a second chance to make sure that every Maine woman who needs contraception that works can get it – regardless of her income.

The new measure, L.D. 319, would provide adults earning about $24,000 a year or less with publicly funded reproductive care – birth control, cancer screenings, annual exams, Pap tests and sexually transmitted disease tests. (It would not cover abortions.)

Of all the services that would be entirely or mostly covered if this bill passes, birth control is particularly important. Women have to use birth control for several decades in order to plan and space their pregnancies; for women who have no health insurance, the expense can add up. The most widely used form of contraception – the pill – can cost uninsured women around $100 a month, for example.

Price is even more of a barrier for uninsured women who want intrauterine devices or contraceptive implants. They don’t cost a lot when averaged out over time (an IUD is effective for up to 12 years and the implant for up to three), but the up-front expenses are prohibitive.


Getting an IUD – a hormone- or copper-emitting T-shaped device, inserted into the uterus – can cost $1,000, including the device itself and the fee for insertion by a health care provider. Similarly, another form of long-acting reversible contraception – the birth control implant, which releases hormones – costs up to $800 for the initial exam, the matchstick-sized device and the insertion into the patient’s arm.

Uninsured women typically don’t earn enough to pay the whole cost of long-acting contraception. So the thousands of Maine women of reproductive age who have no health coverage can’t afford implants or IUDs, the two most effective forms of birth control. (In any given year, less than 1 percent of women who use long-acting contraception will get pregnant, compared to 9 percent of women on the pill.)

Maine taxpayers would also benefit from making more-effective contraception available to more Maine women. In 2008, the state of Maine spent around $12 million to cover costs of 3,500 births resulting from unplanned pregnancies (prenatal care, labor and delivery). By reducing the number of unintended pregnancies, L.D. 319 would save the state an estimated $3 million-plus a year.

Gov. LePage will undoubtedly come out against L.D. 319 as duplicative and wasteful, failing to acknowledge the coverage gap caused by his administration’s drastic cuts in MaineCare and in funding for family planning clinics. Now is the time for legislators to push back and to craft a women’s health agenda that actually puts women first.

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