Some people with disabilities pay out-of-pocket for birth control, according to a new study from the University of Pittsburgh. Researchers say this policy harms an already marginalized group.
Medicare is not required to cover contraception to prevent pregnancies. However, it will pay for birth control if prescribed for other medical reasons — such as endometriosis or menstrual migraines.
Most Medicare enrollees are 65 or older and, therefore, don’t need birth control. But, the program also provides insurance to people with disabilities: Nationwide, that includes nearly 1.4 million women of childbearing age, according to the analysis by Pitt researchers.
Medicare is an outlier when it comes to birth control. Federal law requires that most health insurance plans cover contraception with no out-of-pocket cost. This includes the majority of employer-based coverage as well as Medicaid — the public insurance program for low-income people that’s jointly funded by the federal and state governments.
To better understand the coverage discrepancy's ramifications, Pitt researchers looked at claims from 2019 from more than 200,000 reproductive-age females with Medicare. They found that just 14.7% had a claim for birth control.
A national policy change is needed, said the study's lead author, Jacqueline Ellison, who researches reproductive health policy at the Pitt School of Public Health. That's partly because people who have disabilities are more likely to live in poverty, making birth control out-of-reach for some Medicare patients.
“Disabled people are desexualized and devalued. People with disabilities are often deemed asexual, but this isn’t true,” said Ellison. “Disabled people have sex, and they deserve reproductive health care that is accessible and person-centered.”
Furthermore, as abortion care becomes increasingly difficult to access in the U.S., Ellison warns that some Medicare enrollees will be forced to carry medically dangerous pregnancies. Previous studies have found that people with disabilities are at higher risk of perinatal complications, including preterm birth and maternal death.
