News, Views and Careers for All of Higher Education
March 22, 2007
You’ve heard the complaints about paying more for tuition and textbooks. The latest sticker shock to be upsetting students: the rising cost of birth control.
A little known provision in a deficit reduction law enacted in 2005 is taking effect this year and leading to sharp increases in costs for students who use prescription birth control. Exact costs vary from campus to campus, but students whose birth control needs could have been financed with $10 to $20 a month now find themselves facing bills as much as $50 a month. That may not sound like a huge increase, but health educators report that many students don’t have an extra few hundred dollars a year in their budgets and are furious about the change. Those frustrations upset health educators, who already worry about students having sex without birth control, and who don’t want any unwanted pregnancies on their campuses. In addition, health educators note that students who seek prescription birth control typically receive guidance on sexual health issues, guidance that might disappear if students are discouraged from these froms of birth control.
“From what we can tell, the change was not meant to affect college and universities,” said Mary Hoban, program director of the American College Health Association’s National College Health Assessment.“But it happened.”
Before the Deficit Reduction Act of 2005, pharmaceutical companies were selling medication, including birth control, at nominal prices to various health institutions, including campus health clinics. As part of a series of complicated changes in Medicare reimbursement rules, those nominal prices have now generally been replaced with standard prices, which are frequently twice the nominal rate, and sometimes three times the rate.
“We are keeping our eyes and ears open about correcting this legislatively,” said Hoban. “However, we hope that we can take care of this in a regulatory fashion.”
The association recently sent a letter to the Department of Health and Human Services, seeking to have college health centers again treated as places that should receive the birth control at nominal and not standard prices. “Many students simply cannot afford increases in the costs of their contraceptive drugs in the face of sharp increases in the cost of their education,” the letter said. “In the long run, the high costs of drugs and services and logistical problems will undoubtedly lead to reduced testing and use of contraception and a higher rate of unintended pregnancy, undetected health problems, and untreated gynecological disorders.”
Hoban said the pricing shift has also made it impossible for campus health centers to — as they have in the past — add a little to the costs of birth control, using the extra funds to provide other services on campus related to family planning and sexual health.
At University of Arkansas at Fayetteville, Mary Alice Serafini, director of the Pat Walker Health Center Women’s Clinic and assistant vice chancellor for student affairs, has been working to identify ways to help students deal with the price increase. The university is helping students find generic brands of birth control where possible and is it planning a new prescription benefit for students that, starting in August, will cover prescription birth control.
“All in all, it is an unnecessary hardship for our women,” Serafini said of the new law.
Student papers have been running columns about anger over the price increases. “With the ever-rising cost of higher education, the last thing college students need is another out-of-pocket expense,” writes Carolyn Smith in The Badger Herald, the paper at the University of Wisconsin at Madison. “With books, food, rent and the like, female students across the nation could be spending hundreds of dollars more per year for contraceptives.”
An article in The Daily Collegian, at Penn State University, quoted one angry student as saying that the price increases were “promoting not using birth control.”
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I can’t believe so many people are bashing college students and their ‘lifestyle’ choice of taking birth control. I am a freshman in college and my birth control is now twice what I was paying last year. My roommates BC shot up for $10 to fifty, by the way she takes it for medical reasons, and lucky for her her mother is paying for it. But, I cannot afford to get it anymore, and yes I do use birth control because I have sex. Should I be punished because I have sex? Should I become pregnant because I have chosen to have sex? A lot of you obviously think so, and even though I use condoms everytime I have sex, I’m not as safe as I would like to be because I can’t afford birth control. Oh and by the way, I don’t drink, so there is no money to be saved from that. Unintended pregnancies WILL go up because of this increase and so will abortions. Contrary to what the religious right would have you believe, their actions of promoting abstinence only sex education only result in more abortions. But, a few of you are right...I’m not suprised.
Paige, at 7:35 pm EST on November 26, 2007
Health education that promotes anything other than abstinence are not high priorities on the present administration’s agenda. It is extremely kind to claim that this was “not intended to affect college students.”
S. G., at 8:56 am EDT on March 22, 2007
There is a voice inside of me telling me not to touch this issue with a ten foot pole, but alas I must.
Pardon me for not feeling a terrible amount of sympathy for users of birth control. For the most part, the pill is a life style choice drug. Granted, a few women may be placed on it for medical reasons, but for the most part the drug is not neccessary to maintain a person’s life. The pill is a lifestyle choice.
My sympathies are with the people who pay hundreds of dollars a month for drugs to literally keep them alive. The people who make the daily choice between eating well (or eating at all) and paying for their medication.
One of the purposes of attending a university is to gain a perspective outside of yourself. It seems that colleges whining about students having to pay more for the pill are missing an opportunity to say to students, “Yes, it may be a hardship to pay $30 a month more, but it is a choice you are making. Let’s consider those who don’t have a choice and pay many times that $30″.
I’m sure I’ll take some flak for that opinion, but it just seems that this is a superficial issue compared to the real issues in drug prices.
TA, at 9:51 am EDT on March 22, 2007
Sounds to me when “Hoban said the pricing shift has also made it impossible for campus health centers to — as they have in the past — add a little to the costs of birth control, using the extra funds to provide other services on campus related to family planning and sexual health” that the a matter of contention is the loss of that expected ‘income’ to health centers. It’s about money then, right? It boils down to the paradox between a removal of a subsidy and the reinstatement of income to pharmaceutical companies.
EB, at 10:36 am EDT on March 22, 2007
TA I don’t understand your point. Just because some are suffering we should make all suffer? Lifesaving drug costs are high and cause suffering. This seems obvious but why should students be deprived of birth control? Does this somehow make the former situation better? Please explain.
gm, at 10:36 am EDT on March 22, 2007
That college age women are concerned with their own well-being — their health, their “lifestyle", and their finances — does not preclude them from also being concerned with poverty in the world around them. How incredibly insulting to imply that women who are concerned with the cost of birth control are shallow and lack perspective. Not to mention the fact that there are plenty of women in college for whom money is a perpetual struggle in very serious ways — women who will graduate a hundred thousand dollars in debt, but hopefully with the ability to change their financial situation.
The legislation enacted doesn’t take money away from BC programs to give it to people who can’t afford their heart medicine, so what’s the connection?
Amanda, at 11:21 am EDT on March 22, 2007
I’m with TA. It’s a lifestyle choice. I’m not too worried about how folks pay for their viagra, and if a 20 year old’s college student’s subsidy for birth control isn’t as large as they’d like, maybe they need to rethink their priorities while in school.
kh, at 11:21 am EDT on March 22, 2007
My point is it seems that colleges are saying that students are entitled to cheap birth control. In the real world, very few are entitled to cheap prescriptions. I have insurance but I pay $130 a month for my prescription. I’m not whining about it or saying the government should subsidize it, I pay it like millions of Americans do each day. I’m not saying it’s right to raise the price on the pill, but what I am saying is a little perspective is needed. When these students graduate, good luck finding $10 perscriptions.
TA, at 11:36 am EDT on March 22, 2007
TA,I tend to agree with you on this one. First, I’m hesistent to touch the subject. It is however, a life choice drug and one that I am not sure should be subsidized, especially if, as it sounds in the article, the substidy is actually a ‘profit’ of a type for the clinic.
Gf, I fail to see where students would be deprived of birth contol. I would hope that the students affected would be be willing to cut back on other ‘life choice’ activities. Splitting the difference would mean $10 or $15 to be dropped from monthly drinking, movie or dining bills. Remember that we are talking about college students, not welfare mothers. We’re talking a couple of beers or an entree a month. This may sound cruel to you but swing back to the cancer patient. If we are going to ask other people to fund someone else’s medicine, I feel much more comfortable asking workers to fund payments for cancer drugs at Bayside Medical Clinic then birth control pills for a Junior at Cal. Berkley. It would be nice if there were lots of money in the pot for everyone to have a full slice but....
stm60, UConn, at 12:06 pm EDT on March 22, 2007
“Before the Deficit Reduction Act of 2005, pharmaceutical companies were selling medication, including birth control, at nominal prices to various health institutions, including campus health clinics.”
As I understand it, this does not only affect the cost of birth control. The students may be most upset by the cost of birth control. But if a student has a cold or some other common ailments, that unexpected/unplanned for cost is also increased. As a student, the campus health center was typically the least expensive option in town for most scripts...and they would tell you if they were not. The issue is beyond just birth control. Some students may be missing extra classes and study time because they are unable to afford the medication for their cold symptoms.
CF, at 12:06 pm EDT on March 22, 2007
A $10 charge for a $130 perscription may be unrealistic but perhaps people should consider some other costs. Raising the price for birth control is most likely to result in reducing the access to it. This will probably result in an increase in unwanted pregnancies. Having a child out of wedlock at an early age is a sentence of poverty for both the mother and the child. This is not a lifestyle choice, it is a terrible mistake. An abortion is, at best, a painful choice and one that women live with forever. College is a time when people make mistakes and do foolish things. We need these students to graduate and get out into the workplace and be productive. To not do something to fix this problem is unrealilstic and foolish.
SG, at 12:06 pm EDT on March 22, 2007
First, to clear up a logical fallacy: Increasing the cost of birth control pills does not necessarily decrease access to birth control, although it may decrease access to that birth control method. It does nothing to alter the costs of other forms of birth control such as condoms, diaphragms, or IUD’s, which are just as likely to see increased usage as a result.
Second, I’ll accept for a moment that some students cannot afford the extra $20-$30 per month (although I agree that for many students it will simply mean spending less dollars on other forms of “entertainment” instead). Can those students accept the economic consequences of pregnancy if their birth control method fails, either to afford to carry a pregnancy to term or to afford an abortion? Can they afford the medical costs associated with contracting STD’s? Women who cannot afford birth control are unlikely to be able to afford other consequences of sexual activity, and should consider that when making their lifestyle choices.
There is no special “right to have sex” for college students, and the idea that they should be allowed to pay less than market value for birth control simply because of their student status is ludicrous. Why not legislate that all women between the ages of, say, 18 and 60 have the right to a reasonable birth control prescription cost instead? Or work toward more sensible legislation for prescriptions in general?
grad03, at 2:05 pm EDT on March 22, 2007
Stm60’s comment, “Remember that we are talking about college students, not welfare mothers. We’re talking a couple of beers or an entree a month.” is an incrediby narrow perspective. Stm60 assumes that all college students are 18-22 years old with a regular influx of money. There are an increasing number of single parents and low-income students enrolling in our colleges and universities who do not spend their money on beer, dining out, or other supposedly frivolous activities. For these students, they very well may need to sacrifice basic necessities for adequate healthcare options. This is a sacrifice that no one should be forced to make, neither a 21 year old who “drinks a couple of beers” or a single parent trying to improve their economic status.
NS, at 2:45 pm EDT on March 22, 2007
I am shocked at the comments from those who claim that being on birth control is a “lifestyle choice” and that college students can simply reallocate funds from their partying and eating out portions of their budget to pay for this.
I, like probably far more than women than you realize, take the pill primarily for health reasons. I began taking the pill at age 17 because of health reasons, not to prevent pregnancy. Back then I was on my mother’s insurance and we had to have our doctor write the insurance company numerous letters explaining the reasons why I needed the pill before they would even pay for the BCP. They, as some on here, forget that BCP are used for many medical reasons, not just pregnancy prevention. And I don’t think that I am in some small minority in needing the pills for this reason.
Also, I’m not sure what kind of stereotype/misconception you have of college students (Partying every night? Rich daddies who pay for everything?) but let me assure you that many college students live below the poverty line on a very fixed budget. To simply say to them, “Oh no big deal, just pay this much more a month and stop whining about it,” seems to be an ignorant statement indeed.
JS, at 2:45 pm EDT on March 22, 2007
Let’s not forget that this is likely just payback to the Pharm companies for their support in the past. It doesn’t appear that anyone else is benefiting from this change. Its not clear from the article how this reduces the deficit in any way.
Brian, at 5:30 pm EDT on March 22, 2007
I am also one that would fall under needing birth control for medical purposes, otherwise I find it difficult to even walk. With that being said, I think that this might become a major issue. Many students cut out on their food budgets in order to pay for other things, and I think that women may start opting to use condoms only, instead of along with the pill (if that). This is concerning and could affect the lives of many young women AND men. I think that doubling the costs will have a strong negative effect, even on those who opt not to have sexual relationships.
SA, at 9:05 pm EDT on March 22, 2007
Considering the conservative religious base of the current administration access to birth control on multiple levels is seen as great social evil. That funds are cut to such programs should surprise no one.
Joseph C, at 4:05 am EDT on March 23, 2007
As a graduate student who is personally affected by the change, the increase in price I experience is from $12 to $40/month. That’s a dollar a day, or a $366 dollar/year increase. As a grad student, this is just another expense that will added to my growing debt. Oh- and cutting the approximately $10-15 I spend in alcohol a month won’t compensate for that increase. While I take birth control for it’s intended purpose, I would also greatly hesistate to go off of it secondary to the additional health benefits I’ve experienced due to taking it. But I’ll survive, though I don’t appreciated being classified as a spoiled brat, entitled to sex and out of touch with the real world.
Emily, I’m affected, at 8:11 pm EDT on April 1, 2007
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As a 17 year old freshman in college, I became pregnant. It was not a “lifestyle choice.” It was rape. The incidence of rape is higher for female college students than that of most other populations of and though the chance of it happening to ME again is slim, I am one of the people who was benefiting from subsidized birth control. A full time student, trying to pay my OWN way through school with a part time job, I don’t have the money to even have that few beers you suggest that I give up. Not to mention the price of my prescription has risen from 12 dollars to 48.50. Thats a BIG difference to compensate for, I have to decide whether a bus pass to get to school, or birth control is higher priority. Giving up either one would leave me just as vulnerable as I was 4 years ago
Beckah, not a lifestyle choice, at 9:00 pm EDT on September 6, 2007