The Contraceptive Mandate: What Is Its RealImpact?

By Susan E. Wills

April 16, 2012

Supporters of the Health and Human Services (HHS) contraceptive mandate endlessly repeat these claims: contraception is an essential preventive healthcare benefit; cost is the chief barrier to access; and those who object to the mandate are "waging war on women."

These are red herrings to distract from the core issue: the Administration's unprecedented violation of rights of conscience and religious liberty in forcing almost everyone who offers or purchases a health plan—including faithful Catholics and most Catholic employers—to cover sterilization procedures, contraceptives, and abortifacients.

Can supporters claim access is a problem, while also asserting that over 99% of sexually active American women age 15-44 have used contraceptives?

Low-income women can't afford contraceptives? They received $2.37 billion in federal and state funding for family planning in 2010. Oral contraceptives are also available from many pharmacies for a few dollars a month.

Even teens have access! Contraceptive use is "virtually universal" among sexually experienced teens (96%), according to an October 2011 report  on teen sexual activity and contraceptive use by the U.S. Centers for Disease Control and Prevention.  The good news is that most teens are now choosing self-control instead of fertility control with hormones and latex. Currently, 57% of girls 15-19 and 58% of boys have never had sex. Since 1988, abstinence rates increased 20% among these girls and almost 50% among boys.

The importance of this trend cannot be overstated, because one-third of sexually active teen girls will become pregnant—despite using contraception—within two years of initiating sex. And young people aged 15-24 acquire close to 10 million new sexually transmitted infections each year. Many STDs are incurable, and annual treatment costs are estimated to exceed $14 billion.

But the contraceptive mandate is not just about access to condoms and pills. Reproductive "rights" advocates hope it will help take fertility out of the control of contraceptive users (who may not always take a pill promptly or use a condom as instructed) and give control to drug companies and doctors, by switching women to expensive "long-acting reversible contraceptives" (LARCs).

In its 1995 "Uneven and Unequal" position paper, the Guttmacher Institute proposed a comprehensive plan to accomplish this through health care reform:

  • All methods must be covered by all plans, along with surgical procedures like sterilizations and abortions.

  • No co-pays or minimums required. This eliminates the barrier of the high upfront costs of implants ($800) and IUDs (up to $1,000), and the monthly or quarterly office visits for injectables.

  • With cost no longer a barrier, only one obstacle remains: Parents! How does a girl on her parents' insurance policy get an IUD without their finding out? The Guttmacher "solution" is reflected in HHS's March 21 "Advance Notice of Proposed Rulemaking":  Spouses and dependents must be included in all policies, and confidentiality and privacy between the insurer and user are mandated. Parents need never know, and the teen doesn't even need to beg, borrow or steal the co-pay from Mom and Dad.
This "solution" to unplanned pregnancy is appalling on many levels, not the least of which is that these more effective methods can pose even greater health risks to girls and women. The estrogen/progestin combination in most methods significantly increases the risk of the two most common cancers in women: breast and cervical cancer. Depo-Provera doubles the risk of acquiring AIDS and other STDs, and even 12 months' use can double breast cancer risk. The contraceptive patch reportedly doubles the risk of blood clots and death, compared to second-generation pills. Nuvaring's manufacturer is facing at least 730 U.S. lawsuits for blood-clot-related injuries and deaths. In a large study of copper IUD users, two-thirds experienced abdominal pain and a 60% increase in bleeding.

So, why do some people think contraception prevents health problems?  And why is it a "war" on women to speak up for their health, and their freedom to say no to this agenda?

Susan Wills is Assistant Director for Education & Outreach, United States Conference of Catholic Bishops' Secretariat of Pro-Life Activities. To learn more about the Catholic bishops' activities on conscience protection, visit