WASHINGTON – Mary Bonheimer wants to wait a few years before having another child. Uninsured and working part time as a waitress so she and her fiancé can split time caring for their 18-month-old daughter, she plans to stay on birth control pills for now.
But Bonheimer, 22, and her friends in Warsaw, Ind., are worried that the local family planning clinic might shut down under the new policies of President Donald Trump. Her sister had a hormonal implant inserted into her arm that will provide birth control for three years, Bonheimer said. Other women she knows are switching to intrauterine devices (IUDs) and other long-acting contraceptives.
Nationwide, family planning clinics are seeing a surge in demand for contraceptive services, particularly long-acting IUDs and implants.
In Indiana, appointments for long-acting birth control methods have jumped by more than 50 percent compared with last year, said Kristin Adams, CEO of the Indiana Family Health Council, which oversees federal and state funding for family planning clinics in the state, including at the Warsaw center. "It's a sad state of affairs that women have to put off childbearing for 10 years because they're afraid of losing their insurance," she said.
As a hedge against the Trump administration's promise to rewrite the Affordable Care Act (ACA) and a House resolution that would allow federal funds to be withheld from family planning groups that provide abortions, legislators in several states are proposing laws that would require all insurers, including Medicaid, to pay for contraceptive services without delays.
New bills in more than a dozen states would allow women to stockpile a year's worth of birth control pills with one visit to a pharmacy.
Other bills in a handful of states would allow pharmacists to prescribe pills and other forms of hormonal birth control without the delay and cost of a doctor's visit.
Advocates for greater access to contraception attribute the nation's 26 percent drop in the rate of abortions between 2008 and 2014 to greater use of highly effective contraception methods. The rate of unplanned pregnancies declined during the same period, as well.
Like roughly 8 million women nationwide, Bonheimer gets publicly funded birth control services. But the local clinic that provides her the services, the Warsaw Family Health Center, and nearly 7,700 others may soon start to disappear, said Bill Albert, program officer for the National Campaign to Prevent Teen and Unplanned Pregnancy.
Low-income women who rely on Medicaid or federally subsidized family planning services are most concerned, he said. They're hearing that funding for reproductive health centers could dry up. "But the monster in the room is repeal of the ACA."