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LETTER TO THE EDITOR: Cost a barrier to contraceptives’ effectiveness

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Laura Jones ("Mandate destroys women's health," Letters to the Editor, Wednesday) mangles some facts and fabricates others. I'd like to set the record straight.

First, under the much-discussed contraception mandate, private insurance plans are required to cover Food and Drug Administration-approved contraceptive methods without additional cost-sharing (such as co-pays). None of those methods interferes with an established pregnancy, and the mandate has nothing to do with funding abortions.

Second, Ms. Jones fails to comprehend a Guttmacher statistic, leading her to state falsely that contraceptive use somehow leads to more abortions. The fact is, contraception is highly effective. Consider that the two-thirds of women who use contraception consistently and correctly account for just 5 percent of all unintended pregnancies. In contrast, the much smaller groups who use contraception but do so inconsistently (for instance, because they forget) and those who don't use contraception at all make up the lion's share (95 percent) of unintended pregnancies in the United States.

The key policy implication of this statistic is that we need to make it easier for women to use the method that best meets their needs. One barrier to more effective contraceptive use is cost. Even for women with private health insurance, out-of-pocket costs can reach hundreds of dollars. The most effective methods, such as the IUD and the implant, can be even more expensive.

Contraceptive coverage without additional cost-sharing removes cost as a deterrent to a woman's choice of contraceptive method. Studies bear this out: When a California health insurer eliminated cost-sharing for long-acting IUDs, implants and injectables, enrollees' use of those methods increased substantially - and the risk of contraceptive failure plummeted. In another study, of 10,000 women in the St. Louis area, when offered any contraceptive method at no cost, two-thirds chose long-acting methods, a level far higher than in the general population.

In short, removing cost barriers nationwide could substantially reduce unplanned pregnancies, unwanted births and abortions.

Finally, the Guttmacher Institute is fully independent of Planned Parenthood Federation of America.

CORY L. RICHARDS

Executive vice president

Guttmacher Institute

Washington

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