The day after the presidential election, Lisabeth Collins called a Planned Parenthood near her home in Echo Park. She wanted to get an intrauterine device, more commonly called an IUD — a type of birth control that can prevent pregnancy for years.
Since Donald Trump became president-elect, many women in California say they’ve started looking into long-acting, reversible birth control methods, in case access to contraception or abortions is rolled back. Trump has not said he wants to restrict birth control, but he has spoken often of repealing Obamacare, which could have that effect.
Collins said 45 people were ahead of her in line when she called the clinic.
“So I was not the only person with that idea,” she said.
Doctors and Planned Parenthood offices across the state report that in the last week an increased number of women have asked about IUDs. The devices are inserted once and some types could even outlast a two-term Trump presidency. Google Trends shows more searches for “IUD” on Nov. 10 than in the previous 90 days.
Experts and medical providers are quick to point out that access to healthcare hasn’t changed yet, and it might not do so after Trump takes office in January. Plus, any changes would take time to implement.
“The Affordable Care Act is still in place right now,” said Cita Walsh, spokeswoman for Planned Parenthood of the Pacific Southwest, which serves San Diego, Riverside and Imperial counties and has been fielding an increased number of calls about IUDs. “For now people can come in and get the birth control they want.”
If Trump overturned the Affordable Care Act as he vowed during his campaign, 20 million Americans would be left without insurance. But recently he’s shown reluctance to repeal the entire law, and has said he wants to replace it with an alternative plan that could keep people insured.
But even without repealing all of President Obama’s signature health law, Trump could still have a big impact on how much birth control costs.
Under the law, contraceptives are on a list of preventive health services for women that insurance companies are required to provide for free. So insured patients don’t have to pay anything for birth control, including for IUDs that can cost more than $1,000 out of pocket.
Coverage of contraceptives has been a somewhat contentious part of the law, and Trump could eliminate it through an administrative change, said Janel George, director of federal reproductive rights and health with the National Women’s Law Center. For that matter, he could strike the entire list of no-cost preventive health services, which includes counseling for sexually transmitted diseases and HIV, annual well-woman visits and breastfeeding supplies such as breast pumps.
“All of that is in jeopardy,” George said, adding that these changes would particularly affect poorer women.
Without the contraception mandate, women would likely have to start paying a co-pay to get birth control. One study found that after the Obamacare rule went into effect in 2012, women on birth control saved about $250 per year.
Annelise Baer, who lives in Glendale, emailed her doctor on Wednesday to ask about getting an IUD. She had gone without insurance for six years before Obamacare.
Now she can get an IUD for free and not worry about the possibility of birth control becoming an expense in the future, she said.
“No one really knows exactly what’s going to stay, what’s going to go,” said Baer, 32. “Better safe than sorry.”
IUDs are much more effective at preventing pregnancy than most other birth control methods but are less commonly used. According to national data on women who use contraception, 25% take birth control pills compared with 11% who have an IUD or an implant.
Since the election, Dr. Sheryl Ross, an OB/GYN in Santa Monica, said she’s heard from an unusually high number of patients about IUDs.
“It brought the conversation much more front and center,” Ross said. Two of Ross’ patients decided to stop taking the pill and made appointments to get IUDs implanted, she said.
The president-elect has also said he wants to overturn Roe v. Wade, the Supreme Court decision that legalized abortion, as well as defund Planned Parenthood, which provides health services to thousands of women — though he can’t do it on his own. He also has expressed support for a ban on abortions after 20 weeks, and anti-abortion groups have said they expect him to follow through.
Collins, 29, said she was more concerned about Vice President-elect Mike Pence — “someone who has preached creationism and abstinence.” Pence signed laws restricting abortion as governor of Indiana and pushed to cut off federal funding to Planned Parenthood as a congressman.
The Affordable Care Act requires that all employer health plans cover contraceptives, which is another area in which change could come, said Alina Salganicoff, vice president and director of women’s health policy at the Kaiser Family Foundation.
It “has really been among the most controversial parts of the ACA, having gone now twice to the Supreme Court,” she said.
Religious companies have sued the federal government, saying they shouldn’t be required to pay for birth control for employees. The most well-known of these cases, Burwell v. Hobby Lobby, created a loophole so these for-profit companies don’t pay for the birth control themselves and instead punt the cost to insurers.
Salganicoff said that a new administration could allow such companies not to offer birth control in their health plans at all.
California’s leaders have said they will try to maintain state residents’ access to healthcare under the new administration. Though states can’t override federal law, there are ways they can try to fill the gaps, said George with the National Women’s Law Center.
States could offer free contraceptives or other women’s health services through state-funded health programs, she said. California, Maryland and Illinois already have laws in place mandating that all the insurance plans they regulate cover contraceptives with no cost-sharing, and other states could follow, she said.
“There’s certainly room for states to be inclusive in coverage, and that’s what we’re hoping,” George said.
California also recently implemented a law that allows women to get birth control at a pharmacy without a doctor’s prescription, though they’d have to pay for it themselves if their insurance doesn’t cover it.
Elizabeth Walker, 33, emailed her doctor to ask about switching birth control methods the day after the election.
She wants to get an arm implant, another long-acting birth control option that can last up to four years.
“That could be a gross overreaction. Maybe at the end of the day our rights will end up the same, our access to birth control will not change,” said Walker, who lives in San Francisco. “But I don’t want to get in a situation where I don’t have control or say over my body.”
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