On June 30, 2014, the U.S. Supreme Court ruled that employers with “sincerely held” religious views could exempt themselves from the Affordable Care Act’s requirement that health insurance plans cover contraception. While the ACA itself survived a constitutional challenge in 2012, the latest decision has implications that extend far beyond the healthcare debate. The Court’s four dissenting judges expressed concern at the “startling breadth” of the decision, which they said paved the way for companies to “opt out of any law (saving only tax laws) they judge incompatible with their sincerely held religious beliefs.”
The ruling also reignited the debate about women’s health and reproductive rights that has continued since the Roe v. Wade ruling 40 years ago, and raised a series of questions. Research has found that providing no-cost contraception can have a range of positive effects, including reducing the number of unplanned pregnancies and their associated costs — up to $12.6 billion a year, according to a 2011 Brookings Institution study. A 2012 study from Washington University in St. Louis found that if no-cost contraception were made available throughout the United States, it could lower abortion rates by up to 78%.
In addition to the medical and financial impacts of no-cost contraception, research has shown that when mothers have access, their children’s incomes and education levels rise. Access also has been shown to improve women’s employment and wage rates in the decades after its introduction.
Given that poverty rates are higher for women and girls in every age group, it’s important to understand if improved access to contraception could improve the prospects of lower-income women. A 2014 study published in the Journal of Policy Analysis and Management, “The Effects of Contraception on Female Poverty,” uses Census data to examine the relationship between legal access to contraception and female poverty rates.
Although the FDA approved the first oral contraceptive in 1960, initially it was not legally available to unmarried women under the age of 21. Various states progressively reduced the age at which single women had access the 1960s and 1970s, and by 1975, all women had legal access at age 18. The study’s authors — Stephanie P. Browne of J.P. Morgan and Sara LaLumia of Williams College — use the differences in timing to construct a quasi-experiment, allowing them to better understand the link between access to contraception and the chances of a woman being in poverty.
The findings include:
- Early legal access (ELA) to birth control (by age 20) is associated with a reduction in the probability that a woman is in poverty by 1 percentage point, both as a direct consequence of access to birth control and through other channels that access to birth control might influence such as continuing education, or gaining greater work experience before starting a family.
- Even after controlling for many of the channels through which birth control access has been shown to positively affect women, such as educational attainment, the authors estimate that birth control access reduces the probability that a woman is in poverty by 0.5 percentage points.
- ELA reduced the likelihood of a woman’s being in deep poverty (defined as below 50% of the poverty line) as much as 0.8 percentage points.
- Because the average poverty rate for nonelderly adult women over the study period ranged from 10% to 15%, the effect of ELA on female poverty is about the same as reducing the state unemployment rate by 1% or increasing maximum welfare payments (under the old Aid to Families with Dependent Children program) by $100.
- Having access to the pill reduces the chance of becoming a young mother (under 21) by 0.4 percentage point. This underscores that preventing unplanned pregnancies, especially teenage pregnancies, is the primary channel through which oral contraceptives could work to reduce poverty among women.
- The effect of early legal access to contraception differs with age, and is greatest for women in their 20s, reducing their chances of poverty by 0.7 to 1 percentage points. Women in this age group are more likely to have left home and will have had time to realize the benefits that delayed parenthood can bring, including extended education or improved occupational choices.
- An association was observed between access to contraception and the likelihood of divorce: For women 30 to 44, ELA was associated with a 0.7 percentage point reduction in the likelihood of being divorced. (Research in 2012 suggests that the reduction in unplanned pregnancies allowed partners to find a better match and thus reduced divorces.)
The authors conclude that, although the effect of early access to birth control “may seem small relative to the persistently high poverty rates experienced by single-female-headed households, it is the result of a very low-cost intervention.” In comparison, the government spends approximately $12 billion on welfare payments through Temporary Aid to Needy Families (TANF), $49 billion on the Earned Income Tax Credit (EITC) and $30 billion on food stamps. The authors therefore recommend that “going forward, when policymakers are weighing the costs and benefits of increasing or decreasing the accessibility of birth control, they should take into account its effects on female poverty rates.”
Related research: A 2012 study published in the New England Journal of Medicine, “Effectiveness of Long-Acting Reversible Contraception,” looked at the failure rates of long-lasting methods of birth control. It found that IUDs and implants were 10 to 16 times more effective than other long-term contraceptive options.
Keywords: poverty, women, contraception, reproductive rights, family