Ending the Great Pill Price HikeCongress, step up for college women before the year ends.
Posted Tuesday, Dec. 18, 2007, at 11:48 AM ET
As Congress dashes madly toward Christmas, it should not overlook a sliver of language that would restore low-cost birth-control pills to women on college campuses.
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StumbleUponMany women can no longer get discounted contraceptive pills while they're at school, thanks to an earlier congressional screw-up. When legislators passed a law called the Deficit Reduction Act in 2005, they apparently forgot to include college and university health centers on a list of providers eligible for special discounts from pharmaceutical companies. (Whoops.) As a result, after the law took effect in January, the price of brand-name birth-control pills has quadrupled, or more, on many campuses. At some schools, fewer students are now filling prescriptions for the pill, while more are coming in for emergency contraception and pregnancy tests, according to the American College Health Association.
The problem should be easy to fix: Congress could simply add college and university health centers to the list of discount-eligible providers by attaching this language to any number of bills. This would cost taxpayers exactly nothing. Some lawmakers, like Rep. Joseph Crowley, D-N,Y., Sen. Claire McCaskill, D-Mo., and Sen. Barack Obama, D-Ill., are pushing to make that happen. The matter is pressing, especially since the government has now blown $1 billion on programs that promote abstinence until marriage and typically badmouth contraception, all without any known benefit. Maybe it's no coincidence that the U.S. teen birth rate just rose for the first time in 14 years, according to the Centers for Disease Control and Prevention. Whatever the case, it's no time to monkey with birth-control access for college students.
For years, college women got a great deal on the pill, paying anywhere from pennies to a few dollars for a month's supply. That arrangement stemmed from a 1990 law, which allowed pharmaceutical companies to give deep discounts to college and university health centers and other safety-net providers without affecting the so-called "best price" they are required to give Medicaid. The deal helped drug companies, too, by building brand loyalty among young women who would likely someday have private health insurance. Over time, though, lawmakers began to fret that drug companies were giving the discounts too loosely as promotions, shortchanging Medicaid in the process. So, in 2005, they came up with a list of providers to rein in the deals. Federally funded family-planning clinics made the cut, luckily. But colleges and universities didn't—in what lawmakers now say was an oversight.
That snafu has taken a fiendishly long time to correct. Early this year, health-care advocates petitioned the Department of Health and Human Services to add colleges and universities to the discount-eligible list. In July, HHS said the list was just fine the way it was. In March, Democratic Reps. Joseph Crowley and Tim Ryan tried to add the fix to a supplemental war-spending bill. But other lawmakers reportedly cringed at mixing birth control with the troops. In November, Crowley and Ryan, along with Democratic Rep. Adam Schiff and Republican Reps. Jim Ramstad and Mark Kirk, introduced a stand-alone bill; and Sens. Obama and McCaskill did the same in the Senate. But despite some bipartisan support, these measures haven't gotten very far. Behind the scenes, conservatives have insinuated that the correction would cost the government money and be a boondoggle for abortion-lovers. "When they tried to slip this in a bill earlier this year, we called it the 'Planned Parenthood discount drug earmark,' " a Republican aide reportedly said. "It will be even less popular now." (Seventy-five percent of Planned Parenthood clinics are actually still eligible for the discounts.)
Meanwhile, some campus health centers stockpiled discounted pills before the new law took effect. But others did not. And either way, by now many have run out and had to pass the new hefty bills on to students. Pills that used to cost from $3 to $10 per month can now go for $30 to $50 per month or more. Even generics can cost several-fold more than the previous price for brand-name products. And some schools have stopped offering birth-control pills entirely, according to the ACHA.
The impact on students can't be good. Some women can still get affordable birth control through their parents' health plans or by finding a nearby public clinic that still offers discounts. But some would rather their parents not know they're on the pill. And many will have trouble getting to public clinics, especially in rural areas. The bottom line is that of the three million college women who rely on oral contraception, some no longer have reliable access. And some will inevitably get pregnant as a result. Women this age appear particularly vulnerable: In 2005-06, the birth rate for 18- and 19-year-olds was three times higher than that for 15- to 17-year-olds.
With its useless and medically inaccurate abstinence programs, the federal government already shortchanges high-school students when it comes to contraception. Now it's adding to the burdens of college women, who need more access to the pill, not less. It's up to Congress to get it together this week and make it easier for college students to protect themselves. The necessary language would fit on a Post-It note. Let's just hope it sticks to something—anything—that makes it into law this year.
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Remarks from the Fray:
As the exact demographic described in the article, I cannot agree more with everything Ms. Schaffer discusses. I've been on the pill since freshman year (I'm a junior now), and the entire time I've relied on my school's student health services to provide it.
When I started, a month's supply was at a measly $5. It went to $10, then to $15 (which is still feasible), but as of this past September (when the pharmacy's stock-piled inventory ran out), the price soared to $42 (just typing that figure makes me so incredibly angry).
My parents didn't know I was on the pill until recently when my mother got the medical insurance bill and saw that the student health service accidentally billed her for my birth control (a very unfortunate experience I'd rather not think about). Even though she's "accepted" this fact, she refuses to help me pay for it -- so its up to me to reluctantly pay the $42 every month.
While I have a job and am able to pay for it, every time I pay $42, that is $35 I could be spending (or saving) elsewhere. I sincerely hope this legislation passes and my faith can be restored in the system.
--kmg387
(To reply, click here.)
As a female, recent college graduate and current grad student, I am exactly the person that these price hikes affect. While it is upsetting that the prices on monthly contraception have risen, I have to say that I don't understand at all why this has to be as big of an issue as it's become. Is the prospect of an unwanted child or hastily-sought abortion really worth a few extra dollars of spending money a month? There is absolutely no excuse for not scraping together the resources to procure birth control. Even if one doesn't want their parents involved in the issue, I can't think of a single female who couldn't find an RA or female friend to drive them to a Planned Parenthood, where birth control can be had for free or inexpensively. Even after price hikes, I was still able to get mine for $20/month, and I was classified as a "higher-income" patient.
The consequences of not being a responsible sexually active person are just too great. If my choice comes to having a new pair of shoes or not having a baby before I'm 100% ready to do so, I'll go barefoot every time.
--burgettk
(To reply, click here.)
So, does this mean that drug companies are banned from offering discounts on drugs unless Congress gives them special permission? Amanda Schaffer's solution is to add (or re-add) colleges to the list of organizations eligible for drug company discounts. Why not get rid of the list altogether and let companies discount drugs whenever they want? If drug companies want to discount drugs, why should governments stop them, especially now as drug prices are climbing?
Why is the government forcing up the price of drugs when companies and consumers want to lower it?
--Silent Cal
(To reply, click here.)
Wal-Mart has the generics for ortho-cyclen and ortho-tri-cyclen for $4/month. While it's clearly a ploy to bring people into their stores to spend $$ on other stuff, it's a lovely price break for everyone who is losing access to low cost birth control pills. The only problem is letting everyone know. (They have SCADS of other generics for $4/month too.)
--bedorah
(To reply, click here.)
The other half of the story is this: We used to buy BCPs for super-cheap from the pharma companies, and sell them to our students for only "regular-cheap" -- and use the difference to fund all the stuff that we couldn't get sufficient funding for, like staff time to explain drug management to newly diagnosed diabetics, or drugs that expire because the strep throat outbreak was milder than expected.
So the big trauma isn't that adult women will have to pay more for their BCPs (some locally have actually found that they were paying us more than their existing private insurance would have charged them) -- or that they'll switch to condoms, which aren't quite as reliable at pregnancy prevention, but can still be had for free at most American universities, and which also prevent the transmission of some two dozen diseases that you can still catch on BCPs -- but that the university pharmacy's budget is screwed.
If we can't get the "free" money from the pharma companies, then either the we'll have to reduce expenses (services), or increase revenue through student health fee hikes and/or state tax increases.
I'd be happy to pay the higher taxes -- but I agree with a previous commenter, who wondered why college students deserve a special break that no one else gets. Put me down for paying taxes to provide universal health care (at least for catastrophic-level expenses!).
One last thought: Do not expect HIV prevention people to be enthusiastic about cheap BCPs. The number one reason for unprotected sex locally is "but I was on birth control pills, and we were exclusive!" Most students really just don't believe that their own partner could have an STD until it's too late.
--once
(To reply, click here.)
(12/20)