You may have heard people suggesting that if you want to be sure you’ll have birth control for the next four years, you should book your IUD insertion appointment now. That’s because January will bring a new political era, and possibly changes in how insurance companies cover birth control.
If You Want Birth Control That Lasts the Next Four Years, Get an IUD or Implant Now
An intrauterine device (IUD) is a set-it-and-forget it birth control method. After an initial office visit to get it inserted, you won’t have to worry about buying birth control—or diapers—for at least five years. If you get the copper type, you’re good for ten. Another option, an implant that lives under the skin of your arm, lasts for four.
Under current laws, your health insurance plan is required to cover most methods of birth control for free, without charging your deductible and without any co-pay. That includes birth control pills, but also long-acting methods like IUDs and implants.
These long-acting methods are the most effective and foolproof out of any type of birth control. They’re also the most expensive: without insurance, an IUD can cost $800 plus whatever your gynecologist charges for an office visit. Over time, that cost may still be cheaper than other methods, but it’s still a major obstacle to getting care. Nobody wants to choose between birth control and this month’s rent.
That’s why you may want to get an IUD now: it’s free, and will last you through one to two presidential terms. If you wait until after the inauguration, though, you might lose that coverage.
We Don’t Know If Everyone Will Still Have Birth Control Coverage in 2017
Donald Trump will be inaugurated on January 20, 2017, and has promised to begin rolling back Obama administration actions, including some or all of the Affordable Care Act, on his first day in office.
A full “repeal and replace” would take a while, and would require the cooperation of Congress. But if Trump wants to gut the act, he could start taking action in the meantime. According to Forbes, he could stop payments to insurance companies for cost sharing reductions, and the insurance companies are allowed to cancel plans if he does. Depending on which campaign promises you believe, Trump may not want people to get dropped from their insurance without a law in place to provide some kind of alternative coverage, so this scenario is possible but unlikely.
Dropping birth control coverage, on the other hand, would be much easier. The ACA doesn’t say a word about IUDs or even birth control in general; it just says that women’s preventive health services will be covered. The new secretary of Health and Human Services could just redefine that term, and poof, the requirement to cover birth control for free would be gone.
Insurance companies could still cover birth control, even without the requirement, but that would be up to each plan, and subject to state laws. Before the ACA took effect, 28 states required contraceptive coverage, according to a report by the Kaiser Family Foundation.
There is one small silver lining: open enrollment doesn’t close until January 31, 2017. That means that if your coverage does change immediately after Trump takes office, you have a week and a half to switch plans.
How to Decide If an IUD Is Right for You
We’ve written a guide to birth control options and an explainer on IUDs. Check those out if an IUD sounds like a good idea. For more information, especially if you’re not sure which type is best for you, talk to your health care provider.
Call around before you visit, though. Some providers are still working with outdated information and may turn you down because of your age or because you haven’t had children. If that’s the case, hang up and call someone else. The American Congress of Obstetricians and Gynecologists says that IUDs are an excellent choice even for teenagers.
Another good reason for calling ahead is that not all providers keep IUDs in stock—remember, they are expensive. Ask if they can have one ready to go at your appointment, so you only have to visit once.
Be aware that, five or ten years down the road, you’ll have to get the IUD removed. This is a quick procedure (basically, your provider just pulls on the strings) but it requires another office visit. And no, it’s not safe to try to remove it yourself.
If an IUD doesn’t sound like the right method for you, that’s fine. Consider your other options, and remember that really none of us know what’s going to happen to our health care next year. That means right now is a great time for any preventive care you’ve been putting off, like checkups or vaccines. And who knows, maybe in the end nothing will change. But at least you’ll be prepared.
Illustration by Angelica Alzona.