Planning Ahead

Many U.S. students have seen a sharp rise in the cost of their contraception lately, a consequence of the federal Deficit Reduction Act of 2005, effective at the start of this year. At Columbia, women have had to account for the price increases on their own, as Health Services can no longer afford to provide for discounted forms of birth control and emergency contraceptives. For the moment, Barnard College Health Services is still able to offer low prices through stockpiles of these medications, but these stores are limited. Although the only real way to ensure cheap birth control for all students is to address the effects of the 2005 DRA through further legislation, Columbia and Barnard College Health Services should be granted the resources to ensure that such stockpiles are maintained in the interim. The financial pinch felt by many Columbia women in the past year is strong evidence that the University should take immediate action and ensure that its students’ health is fully protected.

Before the DRA was enacted, drug companies offered student health centers substantial discounts for contraception. The new law has made it much more expensive for pharmaceutical companies to do so, a side effect of changes to the way drug companies report their Medicaid rebates. As a result, students who previously relied on Columbia Health Services for their contraception are now responsible for their own co-pays, a charge that can run from $10 to $30. The danger of this change is that many women may switch to generic forms—a transition that can cause grave side effects—or stop taking contraceptives altogether. Further, students have to pay full price for Plan B—the so-called “Morning After Pill”—as it is no longer covered by most insurance plans. And if Barnard’s stores of inexpensive birth control expire, its students will face the same financial hurdles.

Both Columbia and Barnard College Health Services should be commended for providing information on their Web sites about neighborhood clinics that provide discounted birth control and free emergency contraceptives. But while this is important and useful knowledge for students, the two institutions ought to begin addressing this issue on their own turf rather than referring students to other locations. It is to the advantage of both schools that sexually active students make healthy and safe decisions, something made easier by on-campus solutions. At the very least, both clinics should receive financial support from their parent institutions to continually stock emergency contraception and subsidize birth control for those unable to afford the price increases—and who may already have elected to stop taking the pill. In the long run, exempting drug companies from reporting the discounts in their Medicaid rebate calculations is the only way to ensure that low prices are available to students. As such, Columbia and Barnard should also lead efforts to support and work with organizations like the American College Health Association to advocate for a change in the law.