Thanks to two generous donations of $1 million to Planned Parenthood of Greater Texas, low income women in northern and central Texas will receive free or subsidized long acting reversible contraceptives (LARCs). The donations were made by the Boone Family Foundation and the Harold Simmons Foundation. The most common LARCs are intrauterine devices (IUDs) and the contraceptive implant. Low income women will also receive free STI testing.
LARCs are more effective in practice than birth control pills because it is impossible to ‘miss a dose.’ LARCs have a failure rate of under 1%, while the pill has a failure rate of 8-9%. For many women LARCs are the best option to prevent pregnancy. They last for 3-10 years depending on the specific contraceptive, although they can be removed at any time.
LARCs often pay for themselves over time compared to the pill, because one device is effective for multiple years. But the upfront cost of $500-900 according to Planned Parenthood estimates is prohibitive to many low income women.
The importance of access to birth control is hard to overstate, particularly for women who cannot afford an abortion or raising a child. An unplanned pregnancy can trap a woman in a cycle of poverty. Currently the U.S. does not require employers to grant maternity leave, so a woman who needs time to care for her newborn can easily lose her job, or be forced to exit the workforce. For a women who stays in the labor market, her potential work hours are reduced by the need to supervise her child, and sky-high childcare costs in addition to the normal costs of raising a child consume a large portion of her income.
There is striking evidence to suggest that offering free or affordable LARCs will have a large beneficial impact. From 2009 – 2013 Susan Thompson Buffet Foundation supplied the State of Colorado with a grant to cover free long term contraceptive implants or IUDs. During this time, the rate of teenage pregnancies fell by 40% and the rate of teenage abortions fell by 42%.
Officials believe that every dollar spent on the long-term birth control initiative saved $5.85 of Medicaid money, which covers the healthcare costs of the poorest women (although it does not pay for abortions in most states). Long term contraception use is rising all over the country, but the average rate of use in America as a whole is just 7%, compared to around 20% in Colorado.
The grants in Texas will not specifically be used to provide teenagers with LARCs, but they will target a large class of women that are most vulnerable to the effects of unplanned pregnancies; these are also the women who are least able to pay for contraception.
It is critical to take action now. Women in Texas are facing from the negative effects of reduced access to family planning services and contraception.
The New England Journal of Medicine published a recent study that found that since Texas closed 82 family planning clinics in 2011 a full 63% of unwanted pregnancies occurred in counties without family planning clinics. When Texas cut Medicaid funding for contraception in 2013, applications for LARCs fell precipitously and Medicaid-funded births rose. These findings also support the claim that the grant-funded access to LARCs will benefit low income women by reducing unwanted pregnancies and births.
The generous funding for LARC access for low income women is a laudable program. However, it is only a single step in the right direction. Providing affordable LARCs to all low income women will require action on the part of the Texas government. The benefits to women’s quality of life would be immense, and the state would ultimately save money on Medicaid spending.
We will support the fight for accessible contraception until every woman can afford the contraceptive that will be most beneficial to her. For many women, the answer is LARCs.