In late September, Michigan’s Republican attorney general nominee, Matt DePerno, erroneously compared the emergency contraceptive Plan B to fentanyl at a conference in Texas, suggesting his state should “ban the pill.” DePerno is not the first politician to propose limiting contraceptive access following the U.S. Supreme Court’s decision to overturn Roe v. Wade, in which Justice Clarence Thomas made it clear that the constitutional right to contraception could be in jeopardy.
Although nearly all Americans approve of and use some form of contraception, many experience barriers to receiving the contraceptive care they desire. Since Roe v. Wade was overturned, Republican leaders have set their sights on restricting methods of contraception, including Plan B and intrauterine devices. The current political climate, characterized by cascading threats to reproductive health care and autonomy, has revealed that obstacles to obtaining contraception could intensify if we do not take action to protect access.
Across the United States, cost prevents more than one in five sexually active women who want to avoid pregnancy from using their desired contraceptive method. This statistic represents millions of individuals who cannot access contraception, including a disproportionate number of people of color, young people and people with low incomes.
In Texas, where I live, the figures are even higher: More than half of uninsured and publicly insured women are not using their desired method of contraception, along with 41 percent of those with private insurance. Texas’ staggering gaps have resulted from a decade-long disinvestment in reproductive health, with policymakers implementing some of the country’s harshest abortion restrictions while they dismantled the reproductive health safety net and refused to expand Medicaid.
Ensuring that people can use their desired contraception should be a priority for many reasons: the extraordinarily high maternal mortality rate, particularly for Black women; the increasing obstacles to obtaining an abortion, and the reality that there is not one method that works for everyone.
But the most fundamental reason is: Ensuring people access to the method they want can give them greater agency and help them fulfill their goals. Providing people with their desired contraception offers them a greater ability to shape their future.
To be clear, contraception is not a substitute for abortion. People need access to both as a part of a full spectrum of reproductive health care. In fact, the two are inextricably linked; the fight for one is the fight for both. Texas provides a cautionary tale – our legislature has a history of restricting abortion while undercutting other reproductive health services.
In addition to battling for abortion rights, policymakers should take bold measures to safeguard and expand contraceptive access. At the national level, senators should not walk away from the fight to codify the right to contraception. Increasing federal investment in the Title X family planning program could also help expand access to people’s desired form of contraception nationwide.
States should pass legislation guaranteeing rights and removing barriers to accessing the full range of methods, including repealing laws that require minors to have parental consent to access contraception, while investing in state safety net programs. Furthermore, expanding Medicaid in the 12 states that have so far failed to do so would provide millions more with contraceptive coverage.
The existing reproductive health landscape in the United States calls for more, not less, access to contraception. As politicians like DePerno advance threats and disinformation, we must prioritize supporting reproductive autonomy to meet people’s desires for themselves, their families and their futures.
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