After Jersey Garcia welcomed her first baby earlier this year in a planned pregnancy, she was shocked to learn that, despite having health insurance through her employer, she couldn't afford to resume her birth control. The IUD had been her reliable form of birth control for years, but she was told she must pay $800 in fees beyond what her health insurance covers. Switching to the birth control pill was also not affordable; the pill will cost her up to $480 per year in insurance co-payments. Both options are out of reach as she takes on the cost of a newborn. Jersey is reluctantly weighing one final option to access a reliable form of birth control: reveal private information on this deeply personal subject to a co-worker who is charged with submitting appeals to the insurance company.
As it stands, health care reform does nothing to minimize or eliminate these costly co-payments for birth control for working women. Women spend on average 30 years over their lifetime trying not to get pregnant. For women like Jersey, that could mean more than $15,000 in co-pays and related fees.
Despite health care reform, many Latinas are still without access to birth control even when they have health insurance. The country is mired in stigmatizing, sensationalized debates about Latinas and reproduction (Latina teens have twice the birth rate of white teens! Latinas are having babies so they can become citizens!). Yet scant attention is paid to the financial, regulatory and social barriers that stop many Latinas from accessing the birth control they seek.
Why is there more focus on stigmatizing Latinas and pregnancy than empowering Latinas to manage their fertility?
Just recently the Department of Health and Human Services (HHS) announced new regulations for implementing health care reform and the Women's Health Amendment beginning in September. I was thrilled to see the new regulations will allow an estimated 31 million people with new insurance plans to access services that ensure a healthy pregnancy - including iron, hepatitis B screenings, well-baby and well-child visits.
Noticeably absent from the White House announcement was a determination as to whether the health care overhaul will offer birth control without co-payments and deductibles, a move that now could be years away. Also missing was recognition of the women most impacted by White House decision-making -- the voices of Latinas, immigrants and low-income women.
The National Latina Institute for Reproductive Health recently conducted focus groups among Latinas of Mexican origin in the Lower Rio Grande Valley in Texas. These women told us how they feel devalued by the fact that they qualify for health services when they are pregnant, but are largely ignored otherwise. As one woman put it when asked what she would need to maintain her health, she would need "to be able to get health care without being pregnant." Public health programs like Medicaid and Title X family planning services ban women without proof of legal residency status, and even make immigrants who can prove legal status wait five years for health care services like birth control.
The fact is: contraception is a critical component of both public health initiatives and women's health care.
Out of frustration that the Latina experience is stigmatized while the Latina voice is silenced, this week a coalition of Latina-focused organizations is sponsoring the Latina Week of Action for Reproductive Justice. Women like Jersey will be speaking out and inspiring others to action with their stories.
When health care reform passed, we were told that all men and women deserved access to affordable insurance coverage and preventative care. For millions of women, birth control, by definition, is prevention.
It's time for the White House to listen to these voices and deliver on that promise for women and their families.
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