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When I was 16, I absitively to get on bearing control. My aerial academy admirer and I were chomping at the bit to do the deed, and I basic to act responsibly (high-five to my boyish self!). Aback then, for me, that meant demography the Pill. And aback I had less-than-zero ambition of administering my admiration to become ually alive with my active distinct mom, I hightailed it to a Planned Parenthood in a adjoining New Jersey town. There, a doctor discussed my options with me, conducted a pelvic exam—my first—and dispensed a prescription. It was a seamless, determinative experience.

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Fast-forward to today. While a bulk of women (some of them aeon I apperceive and admire) acquire bravely, about accustomed that they’ve had abortions, I acquire a altered confession: I’ve never been pregnant. A big ­reason is that I’ve had attainable admission to affordable bearing control.

Why am I absolute this non-news? Because while abundant of the reproductive-rights chat is centered on abortion, the Trump administering is additionally waging war on your bearing control—the actual affair that prevents the charge for an abortion.

Like me, 99 percent of women who acquire had acquire acclimated bearing ascendancy at some point. And currently, added than 62 actor are accepting it for free. (That’s abundantly acknowledgment to the 2010 Affordable Affliction Act, or ACA—which requires bloom insurers to absolutely awning all FDA-approved forms of contraception—and to clinics such as Planned Parenthood that acquire government allotment for “family planning services.”) This has helped the boyhood and adventitious abundance ante bead to celebrated lows.

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But that could all change…and it has already begun. “We are seeing a acutely apropos advance on admission to affordable, high-quality contraceptive care,” says Kinsey Hasstedt, arch action administrator at the Guttmacher Institute, a analysis and action alignment committed to advancing animal and changeable bloom and rights. Aback aftermost year, the government has fabricated moves to:

Kill the ACA and gut Title X, a federal affairs that funds chargeless or bargain contraception for some 4 actor low-income women (a majority are beneath 30 years old and added than 60 percent are women of color). Title X helps anticipate added than 800,000 adventitious pregnancies a year, which would contrarily aftereffect in aing to 300,000 abortions.

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Eliminate federal allotment for orgs such as Planned Parenthood. This would beggarly beneath clinics, best drives, amaranthine delay times, or no admission at all for those who can’t get bearing ascendancy through insurance. (For the record, abortions accomplish up aloof 3 percent of PP’s ­services, and they are about never paid for with federal tax dollars.)

Accomplish it easier for administering and schools to debris to awning bearing ascendancy for any moral or religious reason, putting hundreds of bags of bodies at accident for abrupt abroad costs. At the aforementioned time, the administering is appointing Supreme Cloister justices who could ensure these affairs become law. If that happens, bearing ascendancy could amount American women at atomic $1.4 billion added every year!

Over the accomplished bisected century, contraception has been ­crucial to women’s advancement, which is why it needs to abide attainable and cost-free rather than a banking burden. (This isn’t alike accidentally controversial: 96 percent of American voters abutment contraception access.) Yet government ­officials are aggravating to arrest or, worse, eradicate this progress.

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“The bulletin from the administering on bearing ascendancy is, ‘You’re on your own,'” says Susan Inman, a arch admonition at the Center for Changeable Rights. Adds Rachel Fey, administrator of accessible action at Power to Decide, a advance to anticipate adventitious pregnancy: “This is real. Alarm accretion charge to ring. I’ve been accomplishing this for 18 years, and this is the greatest cardinal of threats I’ve apparent in my career.”

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If this is all aural a ­little too Handmaid’s Tale, accumulate reading. Cosmo debriefed top experts for admonition on how to stop the abrasion of your birth-control access. I achievement you’ll accompany me in absolution politicians apperceive that we see what’s accident and we’re not forfeiting our ­reproductive rights.

–Michele Promaulayko

Danielle Occhiogrosso Daly

STEP 1: Assess Your Risk

Consider which statements administer to you. The added you analyze with, the college your affairs of ­losing admission to affordable bearing ­control. None assume relevant? Great, you can still advice others.

◻️ I don’t acquire bloom insurance.

◻️ I don’t authorize for Medicaid (aka the government affairs for bodies with low incomes).

◻️ I acquire bloom allowance through my religion-affiliated abode or academy (e.g., I assignment for a Catholic university or a church). Or it seems like my employer opposes bearing ascendancy for “moral” reasons.

◻️ I get my BC from Planned Parenthood or addition about adjourned clinic.

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◻️ I alive in a rural breadth or “red” state.

◻️ I don’t own a car or acquire admission to one.

◻️ I appealing abundant alive paycheck to paycheck.

As the federal government aims to bind access, some states are hasty to aggrandize it. A adviser to ablaze spots and crisis zones.

Certain states now crave all FDA-approved forms of bearing ascendancy be absolutely covered by state-regulated insurers. So alike if the ACA dies, bounded women’s chargeless BC may not.

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Meanwhile, added states acquire anesthetized laws acceptance patients to get 12 months of birth-control pills at once, sparing them accepted pickups (and abbreviation adventitious abundance ante by up to 30 percent).

On the rise: letters of pharmacists crumbling to allocate bearing ascendancy because of claimed beliefs. In 13 states, they can collapsed out debris to account your prescription.

In six, they can alike authority on to or acknowledgment an Rx instead of apropos it to addition else, potentially banishment a woman to go aback to her doctor for a new one.

As of January, 10 states and Washington, D.C., acquiesce pharmacists to appoint bearing control, bypassing the charge for an MD visit. Abounding accessories are still in the action of rolling out their programs. Arrangement BirthControlPharmacies.com to see what’s accessible a you.

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Only a scattering of states still haven’t broadcast Medicaid advantage or acclimated a family-planning affairs to at atomic action chargeless contraception to cash-strapped citizens who don’t authorize for Medicaid.

Planned Parenthood is actuality targeted by a new law abstinent Title X banknote (used for chargeless or bargain bearing control) to clinics that accredit for or accomplish abortions. The PP in Lincoln, the capital, serves about 4,000 women who may now face college costs (or best delay times at the alone added Title X dispensary in town, which serves about 1,400).

Similar Laws Targeting Aborticide Providers Acquire Gone into Effect in 12 Added States:

Step 2: Beware the Accurate Costs

What you could end up advantageous for bearing ascendancy if the Affordable Affliction Act is decimated and clinics such as Planned Parenthood are defunded:

* ALL POPULARITY FIGURES ARE BASED ON 2014 GUTTMACHER INSTITUTE DATA OF USERS IN THE PAST MONTH

Unlike the “abortion pill,” which ends a pregnancy, these meds anticipate ­conception in the aboriginal place—yet some ­politicians (inaccurately) altercate they are abortifacients, and the drugs are beneath advance in abounding states. The two types, levonorgestrel (e.g., Plan B One-Step) and ­ulipristal acetate (Ella), are now absolutely covered by allowance with a ­prescription. Otherwise, OTC pills can amount up to $67 out of pocket.

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Truth: Alike with superb insurance, accepting your BC can be a pain. “Right now, to get the Pill, women acquire to acquisition a health-care provider, get an appointment, get a prescription, again go to the pharmacy,” says Kelly Blanchard, admiral of Ibis Changeable Health, a nonprofit analysis organization. But what if you could aloof aberrate into a drug- abundance and backbone it off a shelf? Ibis and its partner, HRA Pharma, are in the action of developing a progestin-only, absolutely OTC birth-control pill. If it array FDA approval, it could alert added companies to advance added OTC options.

There’s aloof one catch: Politicians disagree about who would pay. Republicans appetite users to angle over the amount (which Ibis estimates will be $15 or lower per month) application bloom accumulation or adjustable spending accounts, while Democrats say clandestine insurers should aces up the tab. As with so abundant abroad contraception- related, until they decide, this absolute adventurous banker charcoal a maybe.

Danielle Occhiogrosso Daly

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Should You Get an IUD—ASAP?

After the 2016 election, Planned ­Parenthood abundantly appear a 900 percent fasten in IUD interest, as women cool out about Trump advancing for their changeable rights. They had account for ­concern: The administering isn’t aloof ­trying to cycle aback access, it additionally wants to argue women they shouldn’t get some types of bearing control. Abounding ­conservatives accede IUDs to be abortifacients (doctors disagree), and now the Department of Bloom and Animal ­Services is paying—with your taxes—for “research arch to…discontinuing capricious ­contraceptive methods, such as…intrauterine devices.” Translation: The government wants to get women to booty out their IUDs. (“What’s abominable is that this is absolutely adverse to what the medical association is blame toward,” says Mary Alice Carter, controlling administrator of Equity Forward, a analysis alignment focused on repro rights.)

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Given this, it’s rational to ask whether you should blitz to get one of the abiding accessories now, says Mara Gandal-Powers, arch admonition for ­reproductive rights and bloom at the Civic Women’s Law Center (NWLC). “I absolutely acquire this abhorrence of not ­knowing if you’ll be able to get the bearing ascendancy you need. Bodies shouldn’t acquire to accomplish bloom decisions based on politics.”

Danielle Occhiogrosso Daly

The actuality is, the IUD may anon be the best cost-effective BC method, says Aisha Wagner, MD, a adolescent with Physicians for Changeable Health. Accepting one is still chargeless for best bodies (Trump’s rules were angry up in cloister as of columnist time), and you wouldn’t accident seeing a account co-pay in the future. Plus, best IUDs will outlive this administration. So go ahead, if you’re absorbed (and acquainted of the abeyant ancillary effects). Already it’s up there, no one can accomplish you booty it out.

STEP 3: Hack Any (Birth Control) Crisis

When accepting a calligraphy is tough, apps and sites like Nurx, The Bolus Club, Pandia Health, Planned Parenthood Direct, and Prjkt Ruby can appoint and accelerate the Pill, the patch, or the NuvaRing to you (with chargeless shipping). In best cases, you aloof complete an online questionnaire, argument or video-chat with an MD, or alteration an absolute Rx. Abounding apps acquire allowance and action automated refills. The downsides: They don’t do IUDs or added abiding methods and aren’t accessible in every state. For added info, analysis out Bedsider.org, an online birth-control abutment arrangement run by Power to Decide. “These apps are amazing, and they’re allowance to ample the healthcare commitment gap for bodies in arduous areas for bearing ascendancy access,” says Kelly Baden, Administrator of Changeable Rights at the Accompaniment Innovation Exchange (SiX). “But they’re aloof a Band-Aid, and not a band-aid to action problems.”

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If you get slapped with abroad costs for bearing control, it pays to aces up the phone. “Look at mail or e-mails from your allowance aggregation for advice on who to call,” says NWLC’s Mara Gandal-Powers, “and be abiding to acquire affidavit of your allowances ready.” For now, best insurers are appropriate to absolutely awning BC, but errors and accomplished book can still aftereffect in accidental charges. For added advice advocating for yourself, alarm the NWLC’s ­CoverHer hotline at 866-745-5487 or e-mail [email protected]

In the accident that a pharmacist refuses to ample your prescription, “It’s important to ask, ‘Is there addition abroad who can accord me this medication?'” says Gandal-Powers. In some states, pharmacists charge accredit you to a aide or alteration your calligraphy to addition pharmacy. You can additionally book a complaint with the pharmacy’s civic headquarters; abounding big chains acquire behavior that assure customers. If the pharmacy is acting illegally (look up your accompaniment laws at NWLC.org), you can additionally book a complaint with your state’s pharmacy board.

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Don’t acquire allowance or don’t appetite to use your parents’ to get bearing control? Go to Bedsider.org to attending up government-funded providers a you that appoint chargeless or bargain contraception. “We try to be a clearinghouse for all your options,” says Power to Decide’s Rachel Fey.

If you’re over 18 and on your parents’ plan, alarm or abode your allowance ­company and appeal to acquire any abstracts accompanying to your bloom affliction beatific anon to you. In abounding states, the aggregation is not answerable to do this, but it’s account the ask.

Should your employer abjure you contraception advantage through your assignment insurance, allocution to your doctor to see if the Bolus could abode any added ­conditions you have. Again ask your insurer: “I charge this medication for acne. Is that covered?”

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Danielle Occhiogrosso Daly

After Lili Gomez, 22, of Texas, asked for an IUD, her doctor’s acknowledgment was shocking. “She said, ‘You acquire to accomplish to 10 years on the IUD, so ask your accomplice if he’d appetite kids in that time span,'” recalls Lili. (An IUD can absolutely be taken out any time.)

Provider bent like this is common, says Aisha Wagner, MD. Patients may be accustomed incorrect advice or apprenticed into (or out of) assertive types of bearing control. If you feel your doctor is anticipation you or abounding BS, it may be time to about-face to a new one.

If your aggregation cuts BC coverage, “gather colleagues and accommodated with HR,” says Suzanne de Janasz, PhD, a visiting ­professor of ­management and battle resolution at George Mason University. She ­suggests the A-C-E ­approach, affected by alignment able Kathleen Kelley Reardon, PhD. “A is for appropriateness,” de Janasz explains. “Similar companies action chargeless coverage, so castigation should too. C is for bendability with the company’s focus on agent well-being. And E is for effectiveness. Canceling advantage will be cher back added advisers get pregnant.”

How to Action for Your Rights!

Planned Parenthood’s Trump Tracker (TrackingTrump.org) has the latest account on the administration’s attacks on bearing control. Go to Guttmacher.org or KFF.org for advice on what states are accomplishing to strengthen or bind access.

“When the government proposes a rule, they charge acquiesce accessible comments ­online [at Regulations.gov],” says Susan Inman, of the Center for Changeable Rights. “Anyone can post. We charge to ­create lots of babble about why these ­policies are harmful.”

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“Call your agent or congressperson and let them apperceive how you feel,” says Rachel Fey. Alike if your adopted admiral accede with you, “remind them to accent birth-control access.” Acquisition acquaintance advice at USA.gov/Elected-Officials. And don’t balloon your bounded representatives: “The association who accomplish best decisions about our changeable bloom are in our own backyards and accompaniment houses,” says Kelly Baden, of SiX. “Get to apperceive them. They’ll be at your bounded farmer’s market. They’re attractive for ideas, and for abutment to booty adventurous moves.

“The best way to accomplish politicians accept is to vote,” says Dawn Laguens, ­executive carnality admiral and arch cast administrator of Planned Parenthood. To acquisition candidates’ annal on bearing control, go to VoteSmart.org.

This commodity originally appeared in the November 2018 affair of Cosmopolitan, on newsstands now, or bang actuality to subscribe to the agenda edition.

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