High Hurdles to Contraception for Sexually Active Teens

If you can’t get contraception, does it really matter if it exists? Welcome to family planning in America, particularly if you are a teen, poor and live in Texas.

Bear with me while I cite a few statistics. According to the Guttmacher Policy Review, more Texas women are in need of family planning services than anywhere but California.  The American College of Obstetricians and Gynecologists reports that “unintended pregnancy rates are highest among those least able to afford contraception.” Most teens can’t afford contraception and, not surprisingly, most of their pregnancies are unintended.

Why this sorry state of affairs exists is complicated. Although our rates of uninsured have dropped, Texas still has the highest rate of uninsured in the nation. And, although Texas citizens pay for the federal Affordable Care Act (also known as Obamacare), Texas has said “no thank you” to a key provision that would allow for an expansion of Medicaid (insurance for the poorest of the poor). By doing so, we are turning our backs on billions of federal dollars that could provide family planning services for those most in need, as well as health care services that save lives. “It’s our money that we are sending to Washington, D.C.,” says Bill Hammond, CEO of the Texas Association of Business. “We are not getting it back.” Sadly, politics are deeply imbedded in this issue, and it is unlikely that this bad decision will be reversed any time soon.

Adding insult to injury, Texas workers pay more for health insurance than in any state other than Florida. Insurance matters because the most effective contraceptives (long-acting reversible contraceptives or LARCs) aren’t cheap, and require visits to a private physician or clinic. They’re a bargain, however, compared to the cost of teen births.

Texas teens must also contend with rules governing parental consent for minors. The use of state funds for birth control requires parental consent. Medicaid does not. This is confusing for teens and health care providers alike because the same facilities often access both sources of funds.

There is one bit of good news headed our way, even though it has a catch. Thanks in large part to the Texas Women’s Healthcare Coalition, there will be a significant expansion in free contraceptive coverage for teens starting next July through the “Healthy Texas Women’s Initiative.” The catch is that parental consent will be required. Texas Campaign board member and vice chair of the Texas Women’s Healthcare Coalition Dr. Janet Realini noted that the parental consent requirement could still be a barrier to reducing teen pregnancy. “Parents worry that if kids have access, that will be a message that it’s OK to have sex. But I don’t think there’s any evidence that that’s really how things operate,” Realini said.

With 7 in 10 Texas teens sexually active by the 12th grade, and one of the highest rates of teen births in the country, we need to facilitate access to contraception. It encourages responsible behavior. It does not promote sex. Get informed, get active, and make your voice and opinion known.

By: Cindy Sesler Ballard, Board Member, Texas Campaign to Prevent Teen Pregnancy