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Comment by craigds | Hacker News Reader

> If you're a woman living in the United States, you already know that getting your hands on birth control can be a complex and expensive process.

I'm not a woman nor in the US, so this was news to me. It's really easy and cheap here in NZ, so it surprised me that this is still a problem in any developed nations.

Can anyone add more background on what the difficulties are in the US?

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Up until recently, it wasn't guaranteed to be covered under your health insurance. The ACA — "Obamacare" — required plans to cover many options, but it's not guaranteed that your preferred option(s) will available. Generally, coverage is supposed to be free, but again, only certain options may be free (generics only, for example) and some may require a significant copay (IUDs, I believe).

For the birth control pill, you still A. need a prescription (which usually means you need to occasionally make an appointment, take off work, and see a doctor, probably not for free), and B. need that prescription to be filled. Oftentimes, that means picking up a new package of pills in a five-day window during semi-limited business hours because many pharmacies avoid giving out an extra supply. Planning for a vacation can be a pain (1-month notice) but an emergency trip is almost undoable.

Not every pharmacy even needs to carry the birth control pill or other options, so it's a very real scenario that people may not have access to their preferred method. Recent court challenges (Hobby Lobby in particular) have made it more complicated and allowed some companies to NOT provide such coverage.

Also, pharmacies have not been above charging women for products that should be free.

Lots more detailed info here: http://obamacarefacts.com/obamacare-birth-control/

IANAW but I am married to one.

On the other hand, you can walk into a Walgreens and get "Plan B" over the counter (without a prescription). Some parts of the US don't do as good a job at stocking it, but in a place like the Bay Area, it's a piece of cake.

Plan B is to be taken as an emergency contraceptive; it is should not be used as a normal, routine method of birth control.

Given how unpleasant the experience is I doubt any woman would choose plan B as a routine contraceptive.

or the birth control pill, you still A. need a prescription (which usually means you need to occasionally make an appointment, take off work, and see a doctor, probably not for free), and B. need that prescription to be filled.

So it sounds as complicated as getting any other prescription drug? I don't see huge barriers here.

In most states, pharmacists can legally refuse to dispense contraception on religious grounds. No federal law prohibits pharmacists from doing so. Only eight states explicitly prohibit refusals and six states explicitly permit refusals. According to the National Women's Law Center, reports of refusals are increasing.

http://nwlc.org/resources/pharmacy-refusals-101/

It's not true in the slightest; it's political propaganda. You can walk into almost any drug store in the United States and buy armfuls of contraception without any difficulty.

It is true that in certain limited cases if a company has a religious objection against contraception, they are not required to pay for it as part of their employees' health plan, but a) that's very, very few employers, b) that doesn't prevent the employees from buying it themselves, and c) the over-the-counter expense of contraception is trivial anyway.

Unfortunately not all forms of birth control are fully subsidised by PHARMAC in NZ, so not always cheap.

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