If you're a woman who, on the internet, has tried to defend widely accessible and affordable birth control, you probably know all the counterarguments by heart: "Why should my tax dollars make it easy for you to have sex?" "I don't want to pay for what you do in the bedroom". "Don't have sex if you can't afford to get pregnant".
Such comments conveniently gloss over the complexities of real life. But it's also easy to trot out similarly simplistic responses when arguing for birth control. Women and their allies are tired of having to defend something that seems basic, but the important thing to remember is that you're not trying to convince the troll. Instead you want to sway the social media audience watching your exchange. You're playing to the crowd.
"Most of these claims or moral arguments don’t take women’s interests very seriously."
That matters because informed public debate of birth control is critical right now. The Affordable Care Act, commonly known as Obamacare, requires insurers to provide federally-approved methods of contraception without a copay. Republicans, who plan to repeal Obamacare but haven't introduced a replacement yet, have indicated their bill won't have the same requirement. Millions of women could lose access to affordable contraception as a result.
Public polling shows that a majority of Americans support full birth control coverage, but Republicans aren't in that camp, and trolling comments on social media can amplify a much different narrative. Some critics will never be convinced, but if you choose to take on their talking points for all to see, here are six things to keep in mind:
1. It's not "free" birth control.
First, the government doesn't send bureaucrats out to roam the streets with bags of free pills and IUDs, tossing them to the nearest random woman. Instead, insurance companies and clinics work with doctors and pharmacies to provide them to patients at no additional cost.
People who receive copay-free contraception typically put their own money into the health care system by paying taxes and private-market premiums. Last year, people with employer-sponsored health insurance paid on average $5,277 toward their family coverage. Low-income Medicaid recipients may also pay premiums for their insurance.
It’s not FREE birth control. We’re asking for coverage by the health insurance we ALREADY pay for.
— Not My President (@missmayn) February 7, 2017
While eliminating the birth control copay saved women a lot of money, they continue to finance their own health care while also subsidizing services for fellow Americans.
2. Birth control is for planning pregnancy.
People who oppose copay-free contraception often associate it with promiscuity or irresponsible sexual behavior. The simple truth is that birth control helps women prevent and plan pregnancy. (It can also alleviate symptoms of medical conditions like Polycystic Ovary Syndrome.) That's pretty thoughtful decision-making, and yet, critics get stuck on sex, a nearly universal expression of human desire and intimacy.
We tend to talk about BC being used in 2 ways: pregnancy prevention or a health issue. But preventing pregnancy is a health issue!
— Jessica Valenti (@JessicaValenti) January 14, 2017
Arguing about why people are having sex, or under what circumstances, is ultimately a distraction from legitimate practical concerns about not getting pregnant. Demanding that people wait to have sex until they’re ready to conceive just isn’t realistic, says Lawrence Nelson, an associate professor of philosophy at Santa Clara University. That logic would make even the most committed married couples chaste.
"Most of these claims or moral arguments don’t take women’s interests very seriously," Nelson says.
3. Preventing unplanned pregnancy is good for women, families and taxpayers.
Under Obamacare, birth control is considered preventive health care, just like vaccinations, routine checkups and breast pumps for new mothers. That may seem odd but making it easy for women to prevent a medical condition — pregnancy in this case — saves the government and taxpayers a lot of money.
In 2010, the federal government spent $21 billion on births, abortions and miscarriages related to pregnancies that weren't planned. Studies suggest that unintended pregnancy leads to worse economic, health and academic outcomes among children. When women avoid getting pregnant at the wrong time, research indicates they're able to get more education and increase their earnings.
Not much of a fiscal conservative if you're unaware that every $1 spent on contraception saves the government $7+ on preg, delivery, & care. https://t.co/qJH5UxFxe9
— Chelsea Polis, PhD (@cbpolis) January 13, 2017
Adam Thomas, an associate teaching professor at Georgetown University's McCourt School of Public Policy, says that increased spending on family-planning services like expanded access to contraception is a wise investment. His research shows that for every dollar the government spends, it saves nearly $6. Another study indicated that savings could be as high as $7.
"Unintended pregnancy is a major public health problem," says Thomas. "Expanding access can address that problem."
4. Birth control can be too expensive with a copay.
Some people love to insist that every woman can afford contraceptive copays if she tries hard enough. But before Obamacare birth control frequently cost women hundreds of dollars a year, depending on the method.
The most effective forms, like the IUD and hormonal implants, had an upfront cost of several hundred dollars. As a result, some low-income women, constantly making hard choices about which basic need to prioritize on a limited budget, used less effective but relatively cheap contraception (i.e. condoms).
"We already know who’s going to suffer the most if and when they roll this back."
Understanding that dynamic is key to tackling the problem of unplanned pregnancy, but there’s almost no point in arguing further with someone who refuses to believe birth control with a copay is out of reach for many women. If they're not willing to believe and trust women's personal experiences, they won't defer to you. And if that person starts mocking a hypothetical woman’s grocery store purchases or cell phone bill, for example, in order to attack her reproductive health choices, the conversation has lost its perspective — and arguably its sense of decency.
"We already know who’s going to suffer the most if and when they roll this back," says Alexis Cole, policy manager for the reproductive justice organization Urge. "It’s those that had the hardest time affording birth control before — young people, immigrants, women of color and low-income families."
5. Yes, some sexually active women don't use birth control. Talk about why.
One stereotype tends to throw the birth control debate into chaos, and it's the notion that many women gleefully have sex without protection, consequences be damned. The opposition to affordable birth control is then built around the idea that women can't be trusted with their own sexuality, so why give them a means to prevent pregnancy. In other words, they just shouldn't have sex.
While it is true that some sexually active women don't use contraception, they make up less than one-fifth of women at risk for unintended pregnancies. That's a small group, but instead of pretending they don't exist, people who support birth control access should talk about the bigger picture.
Studies suggest that disadvantaged women, in particular, are ambivalent about unwed motherhood. The possibility of an accidental pregnancy doesn't constrain their risky behavior because they don't feel like they have much to lose, says Thomas.
Ensuring they have access to sex education and affordable birth control is important, but it might actually be more effective to improve their economic prospects. To hold those women up as a rationale for denying everyone affordable birth control fundamentally misunderstands their predicament.
6. Beware the slippery slope of refusing to "pay" for someone else's medical intervention.
If someone refuses to subsidize no-copay birth control on principle, do others then have the right to withhold their taxpayer dollars from financing medical interventions they find objectionable? The natural birthing mom might insist that her premium doesn't go toward medically unnecessary cesarean sections. Or Scientologists could demand their money never pay for psychiatric services because it violates their belief system.
Nelson says people can't plead a special exemption for their objections to birth control. Everyone who pays into the private or public health care system might have very specific wishes for how that money is spent, but that's not the bargain we've made to ensure people are healthy and have access to preventive care and essential medical treatment.
"To say this is different strikes me as not taking women’s lives as they’re really lived seriously, and what it means to a woman to get pregnant when she doesn’t want to get pregnant," says Nelson.
What it comes down to, he adds, is making birth control accessible and affordable so women are tied to the future they create for themselves, not their fertility.
"For women to really be able to live in the world as equals to men," Nelson says, "they need control over their sexual reproductive lives."