With the impending presidential election on her mind, Grady senior *Charlotte Jones entered her gynecologist’s office to discuss contraception options. During her consultation, Jones’s gynecologist recommended a long-acting reversible contraception: an Intrauterine Device (IUD). Since her October visit and the November election results, Jones has scheduled the procedure for her IUD this March.

“It probably wouldn’t have been on my mind or seemed like a very big deal if we had a more secure health care future,” Jones said. “Now with everything on the chopping block, I feel like I need to do this before I end up paying tons of money or am forced into options that I don’t want to be in.”

Jones is referring to President Donald Trump’s announcement to repeal the Affordable Care Act (ACA), which Former President Barack Obama signed into law Mar. 23, 2010. The law required all Americans to have health insurance by 2014 and offers different healthcare options.

“The passage of the ACA was a great day,” said Laura Colbert, Director of Outreach and Partnerships at Georgians for a Healthy Future, a nonprofit focusing on bringing affordable healthcare to all Georgians. “In Georgia, we’ve seen a lot of good impact from the ACA. Our uninsured rate has dropped from 20 percent to closer to 13 percent. We’ve also seen big insurance gains in populations that haven’t previously had large numbers of insured people.”

No matter the insurance plan, the ACA required that many woman-focused preventive care services, such as sexually-transmitted disease testing, cancer screening or easy access to contraception, be covered by most health plans without copays or deductibles.

“I think that contraception is absolutely imperative for many, many women, and the system that we ought to have in place is one that allows women to be able to purchase the kind of contraception that they desire,” former Georgia U.S. Representative Tom Price in his confirmation hearing for U.S. Secretary of Health and Human Services.
Price, who will work with Trump to repeal the ACA, voted in 2011 to eliminate Title X, a program that subsidizes contraception for low-income women. In 2014, he supported Hobby Lobby, a company that claimed covering emergency contraception would violate religious liberty.

“It’s when Tom Price’s name came up that it became clear that reproductive rights would be on the chopping block,” said Lillian Schapiro, a gynecologist at Ideal Gynecology. “Price has said every woman who wants contraception can get it; maybe they can in his world, where everyone has money. In the real world, it’s a real problem.”

If the ACA were to be repealed, an estimated 55 million women could lose access to no-copay preventive services, according to Planned Parenthood, a nonprofit that offers reproductive health services. Many speculate that the repeal of the ACA will cause a price increase in contraceptives.

“If someone is on the pill, patch, or something that needs to be regularly renewed, an ACA repeal may mean insurance will no longer cover them,” said Megan Gordon, Public Affairs Coordinator and Lobbyist at the nonpartisan nonprofit, Feminist Women’s Health Center in Atlanta. “Women are opting, while they still have the coverage, to get long-acting reversible contraception so that their ability to access contraception may be less jeopardized. It speaks to the fact that sex is a fundamental part of people’s lives, and they want to do it in a way that’s safe and allows them to decide whether or not they have children.”

In a recent prediction, Amino, a consumer healthcare company, surveyed 620,000 American women to approximate the current median cost of an IUD in each state. With the ACA, the average cost for a Georgian to receive an IUD is $326, whereas without the ACA, the predicted average cost increases to $1,196.

“Right now [women’s reproductive health] has a wonderful privileged status,” Schapiro said. “Since I opened my practice in October, I have put in 40 IUDs; in the past I put in two per month. What I talked to people about is how we’ve become used to birth control being covered and it’s going to be a whole different mindset now.”

According to Planned Parenthood, the number of women who visited its clinics about IUDs has increased 900 percent since the election results. An IUD is a small object that is inserted through the cervix and placed in the uterus to prevent pregnancy.

Grady senior *Isabella Williams said her mom recommended she think about getting an IUD immediately after President Trump’s inauguration. Williams, although still considering all her options, sees IUDs as an attractive option due to their reliability. There are three types of IUDs available, and some can last up to 12 years with a failure rate of .2 percent to .8 percent.

“It doesn’t depend on you taking it everyday, and it’s something you can count on,” Williams said. “Especially going into college, you see the dropout rates are higher because of pregnancies, so I think those four years are especially important to remain protected.”

While President Trump has not revealed his alternative plan, in a U.S. Senate meeting on Jan. 12, the Republican majority house blocked a series of amendments that would protect certain aspects of the ACA from repeal.

“The politicians need to see the number of people [who disagree with their decisions],” Schapiro said. “People need to contact their senators and representatives. Trump can’t do these things by himself.”

One blocked idea was Sen. Kirsten Gillibrand’s amendment, which would continue to protect the ACA’s provisions for women’s health care.

“Contraception tends to be debated differently than other kinds of healthcare; there tends to be a lot of moral judgment attached to it,” Gordon said. “It feels like we’ve been having the same conversation for about 100 years. People are wanting to make policies based on their own moral judgments instead of making policies to make sure people have the things they need to flourish.”

Birth control pills were introduced in 1960 and were the first contraception available to American women. This sparked the national debate about women’s reproductive rights with landmark cases such as 1965’s Griswold vs. Connecticut and 1973’s Roe vs. Wade.

“It’s shocking that we’re still having to have these kinds of arguments about women’s rights,” Williams said. “It’s been so many years. We should be at a point where women are allowed to do what they want with their bodies.”

*Students names have been changed to maintain anonymity.