If you’re like me, your uterus was doing the Electric Slide with excitement last year when the Obama Administration announced that birth control would be covered under the Affordable Care Act (ACA). Preventative benefits without cost sharing? Um, yes please. As if I wasn’t overjoyed already, I was even more thrilled to hear the recent news that Long Acting Reversible Contraceptives (LARCs) such as Intrauterine Devices (IUDs) and the hormonal implant would also be covered by ACA.
The incredible effectiveness of IUDs and the hormonal implant as well as the flexibility to remove the device at any time make LARCs a fantastic contraceptive option for all women. Mirena, a hormone-releasing IUD, is over 99% effective and once inserted by your health care professional, can last for up to 5 years. Paragard is a non-hormonal IUD made with copper which is also over 99% effective and lasts up to 10 years. The hormonal implant, Nexplanon (formerly known as Implanon) is a single rod which is inserted into the upper arm, is also over 99% effective and can last for up to 3 years. All three devices can be removed by your health care professional at any time.
It also seems that the word is getting out about how awesome and effective LARC’s are. In a Guttmacher study, researchers found that between 2002 and 2007, the number of women using LARCs increased from 2.4% to 3.7%, and by 2009, more than doubling the amount of use with a total of 8.5% of contraceptors using these devices. For young women aged 15 – 19, 4.5% use LARCs, with only 0.5% using the hormonal implant Nexplanon/Implanon.
Personally, I used to completely disregard LARCs as a viable option for my own birth control. I thought of them as some ancient, strange method that my mom probably used in the 70’s – definitely NOT an option for a hip and trendy young Millennial. What I was totally ignorant to (besides the fact that no one would ever call me ‘hip’ or ‘trendy’) were all of the incredible benefits that using a LARC would provide me and other young women. Recently, more health care professionals have come forward to affirm that LARCs are a great contraceptive choice for women of all ages, not just those who have previously given birth. In October 2012, The American Congress of Obstetricians and Gynecologists (ACOG) recognized that LARCs were a safe and extremely effective option for young women, publishing a report strongly recommending LARCs for women aged 15-19.
Ok, so now let’s talk money. You might say ‘LARCs sound fantastic! I want one right now! Let’s do this thing!’ and I would totally agree with everything you’re saying, but also would remind you that it’s important to consider the details. LARCs can cost anywhere between $400 – $1,000 depending on the device and your insurance provider – a pretty hefty chunk of change, which has deterred women from choosing the method in the past, even though the benefit usually outweighs the cost over time. This is one of the prime reasons why the announcement that the Affordable Care Act is covering LARCs is so fantastic – if the cost of the device is covered by insurance, more women can feel financially unburdened about making the choice to use a LARC.
It is true that the roll-out of the ACA in regards to coverage of birth control has been quite a confusing process in which a lot of women are asking for the fine print regarding the cost of their particular method. Getting a LARC means considering the cost of several things: the insertion procedure, the removal procedure, and the device itself, and so far what we know is that the ACA covers the device and insertion, but there is no word on whether or not the removal procedure is covered under ACA as well. Throughout the implementation of contraceptive coverage, inquiries have come center stage in response to what these new laws mean for women’s access to birth control. We can only hope that as we learn more about this new addition to the ACA, questions and investigative research lead to more informed answers about the details of coverage for LARCs for all women.