A small group of Amherst students gathered in the Women’s and Gender Center on Monday evening for an event titled “Election Ruined Plan A? We’ve Got Plan B.” The event, hosted by the Student Health Educators and health center staff, was an information session about intrauterine devices and emergency contraception, topics that some students have been inquiring about in the aftermath of President-elect Donald Trump’s victory.
“We’ve been talking about having an information session or a panel on IUDs for a while,” said Tess Frenzel ’17, one of the Student Health Educators at the event. “But after the election, when people were more concerned about access to birth control and whether it would be covered or not, it seemed more relevant.”
Trump’s election has raised questions nationwide about whether the new administration could restrict access to reproductive health services like birth control and abortion. While current students are less likely to see these services significantly restricted, health center staff say that students moving outside of Massachusetts after graduation should be particularly aware of the changes that could occur under Trump.
“I’m still personally hopeful that we will still have these services covered, but I also believe in being prepared for that not to be the case,” said Dr. Emily Jones, the director of Keefe Health Center.
It is too soon to know how exactly Trump’s presidency will affect reproductive health access, but the president-elect has said he supports greater abortion restrictions and hopes to appoint a Supreme Court justice who would overturn Roe v. Wade. Trump has expressed contradictory opinions on Planned Parenthood in the past, but has recently supported defunding the organization. When Vice President-elect Mike Pence was in Congress, he introduced a bill that would defund Planned Parenthood, and has made attempts to restrict abortion access both in Congress and as governor of Indiana.
Representative Tom Price of Georgia, who Trump has picked to be Secretary of Health and Human Services, is also a staunch abortion opponent who supports defunding Planned Parenthood. Price, who has long argued that the federal government should have less influence in health care, has introduced a detailed plan to repeal the Affordable Care Act. He has also said that requiring insurers to provide free birth control is a violation of religious freedom.
Currently, Affordable Care Act regulations require insurance companies to cover all methods of FDA-approved birth control at no cost to patients. This means that most birth control pills, emergency contraception and forms of long-acting reversible contraception such as IUDs are free with a prescription under nearly all insurances.
However, the Republican-controlled Congress plans to repeal and replace the Affordable Care Act, and the Trump administration could restrict access to birth control even before that happens. As Vox’s Sarah Kliff has reported, the Affordable Care Act lets the Department of Health and Human Services define which “additional preventive care and screenings” for women must be covered. Right now, birth control must be free because federal regulations define it as “preventive care” for women, but that could be changed during Price’s tenure.
In 2012, Price claimed in an interview with ThinkProgress that “not one” woman has trouble affording birth control.
“I guess he doesn’t talk to poor women or college students,” said Denise McGoldrick, Amherst’s director of health education. McGoldrick said some birth control pills can cost as much as 70 dollars a month if they’re not provided for free through insurance. “That’s a chunk of change for a lot of college students,” she said.
Some students take expensive forms of birth control because they have found that certain pills work better for their bodies. One of these students, Stephanie Kelemen ’17, said her birth control is currently free, but she isn’t sure whether that will change under the new administration.
“I am worried that a Trump presidency will mean that I will need to go through the uncomfortable process of finding an inexpensive pill that works for me,” Kelemen said.
Even if the federal government decides to stop requiring insurance companies to provide free birth control, Jones said it is likely that most companies will continue doing so in order to appeal to their customers.
McGoldrick said she does not anticipate birth control access at Amherst changing even if the Affordable Care Act is repealed. Jones also said that if regulations on birth control change, the college would have some ability to lobby Amherst’s student insurance carrier, Gallagher Insurance, to ask for birth control to remain free. About half of Amherst students are on the Gallagher plan, and half use another private insurance carrier.
After the election, Planned Parenthood clinics nationwide saw an increase in inquiries about birth control. Some people, worried about their future access to birth control, are turning to IUDs and other long-acting birth control methods that can outlast a presidential term. The Planned Parenthood League of Massachusetts scheduled 265 IUD insertions in the six days following the election — more than five times the number of insertions scheduled in the six days before the election.
Alyssa Pawlowski, a nurse practitioner at Keefe Health Center, said that some students have been reaching out to her with questions about contraception in the days since the election. “There’s been somewhat of an increase, but people have always come in asking for IUDs and emergency contraception,” Pawlowski said.
Students at Amherst who want to get an IUD can see the health center for a first visit before getting a referral to local providers who perform IUD insertions. Students on the Gallagher insurance plan can complete that entire process, including the initial office visit, with no co-pay.
Pawlowksi said that graduating seniors who move to areas of the country where reproductive health care is less widely available should be more conscious of their insurance options.
“I think it will just fall on the individual a little more to try to seek out the insurance plans that cover the services that are going to be most applicable to them,” she said.
Some students are also worried about abortion access being restricted under Trump.
“One thing that really worries me is what happens with the Supreme Court,” said Jessica Maposa ’17, who works in the Women’s and Gender Center.
Although many legal experts say it is unlikely that even a more conservative court would completely overturn Roe v. Wade, the Supreme Court might limit abortion access in other ways.
Student insurance at Amherst also covers abortion, as do most forms of private insurance. Massachusetts has some of the most liberal abortion laws in the country, which means that abortions will still be more accessible in Massachusetts even in the unlikely event that Roe v. Wade is overturned.
“I think it’s different for those of us in Massachusetts,” said Jesse Beal, director of the Women’s and Gender Center. Beal said abortion restrictions are much more likely to impact low-income women in rural areas who may not be able to travel to their nearest abortion provider.
Pawlowski also said that if Planned Parenthood loses its federal funding, low-income women could face additional obstacles to getting abortions.
“There are still hopefully going to be private offices where you can get it done,” Pawlowski said. “The piece that’s going to end up lacking is people who are in underserved populations, who don’t have the access to OB-GYN offices and rely on Planned Parenthood.”
Ultimately, Pawlowski said Amherst students should remember that any changes to reproductive health services will likely have gradual effects. “I don’t know that anything will happen immediately,” she said.