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Birth Control Sticker Shock
Little noticed provision in federal law leads to costs doubling at many campus health clinics -- infuriating those who use the pill.
You've heard the complaints about paying more for tuition and textbooks. The latest sticker shock to be upsetting students: the rising cost of birth control.
A little known provision in a deficit reduction law enacted in 2005 is taking effect this year and leading to sharp increases in costs for students who use prescription birth control. Exact costs vary from campus to campus, but students whose birth control needs could have been financed with $10 to $20 a month now find themselves facing bills as much as $50 a month. That may not sound like a huge increase, but health educators report that many students don't have an extra few hundred dollars a year in their budgets and are furious about the change. Those frustrations upset health educators, who already worry about students having sex without birth control, and who don't want any unwanted pregnancies on their campuses. In addition, health educators note that students who seek prescription birth control typically receive guidance on sexual health issues, guidance that might disappear if students are discouraged from these froms of birth control.
“From what we can tell, the change was not meant to affect college and universities,” said Mary Hoban, program director of the American College Health Association's National College Health Assessment.“But it happened.”
Before the Deficit Reduction Act of 2005, pharmaceutical companies were selling medication, including birth control, at nominal prices to various health institutions, including campus health clinics. As part of a series of complicated changes in Medicare reimbursement rules, those nominal prices have now generally been replaced with standard prices, which are frequently twice the nominal rate, and sometimes three times the rate.
“We are keeping our eyes and ears open about correcting this legislatively,” said Hoban. “However, we hope that we can take care of this in a regulatory fashion.”
The association recently sent a letter to the Department of Health and Human Services, seeking to have college health centers again treated as places that should receive the birth control at nominal and not standard prices. "Many students simply cannot afford increases in the costs of their contraceptive drugs in the face of sharp increases in the cost of their education," the letter said. "In the long run, the high costs of drugs and services and logistical problems will undoubtedly lead to reduced testing and use of contraception and a higher rate of unintended pregnancy, undetected health problems, and untreated gynecological disorders."
Hoban said the pricing shift has also made it impossible for campus health centers to -- as they have in the past -- add a little to the costs of birth control, using the extra funds to provide other services on campus related to family planning and sexual health.
At University of Arkansas at Fayetteville, Mary Alice Serafini, director of the Pat Walker Health Center Women’s Clinic and assistant vice chancellor for student affairs, has been working to identify ways to help students deal with the price increase. The university is helping students find generic brands of birth control where possible and is it planning a new prescription benefit for students that, starting in August, will cover prescription birth control.
“All in all, it is an unnecessary hardship for our women,” Serafini said of the new law.
Student papers have been running columns about anger over the price increases. “With the ever-rising cost of higher education, the last thing college students need is another out-of-pocket expense,” writes Carolyn Smith in The Badger Herald, the paper at the University of Wisconsin at Madison. “With books, food, rent and the like, female students across the nation could be spending hundreds of dollars more per year for contraceptives.”
An article in The Daily Collegian, at Penn State University, quoted one angry student as saying that the price increases were "promoting not using birth control."
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