Access to Essential Reproductive Healthcare in North Carolina: The Influence of Politics

Policy Problem Statement

On January 1, 2000, North Carolina’s Contraceptive Equity law went into effect. For the past fourteen years, the law has mandated that North Carolina insurance plans provide coverage for contraception. This legal mandate on insurance plans is independent of the recent Burwell v. Hobby Lobby Supreme Court decision, which holds that “closely held corporations” can choose not to abide by the Affordable Care Act contraceptive coverage mandate. At the national level, Burwell v. Hobby Lobby cites the Religious Freedom Restoration Act (RFRA) as reason to allow employers to refuse female employees contraceptive coverage. At the state level, North Carolina’s Contraceptive Equity law plays an important role in protecting reproductive rights. However, with certain specific modifications, the law can have an even stronger impact.

The purpose of the North Carolina Contraceptive Equity law is to provide protection of contraceptive coverage for women. On further examination, however, the current law excludes provisions necessary to protect contraceptive coverage for poor women. Additional provisions are required in order to more equitably protect their reproductive rights, since uninsured women are unprotected by any of the law’s provisions and women relying on Medicaid have limited contraceptive choices regarding type and brand. Additionally, women who receive insurance under their employer may soon see increased restrictions on their contraceptive options. In fact, more than half of pregnancies in North Carolina are unintended, and these pregnancies place a heavy burden on state Medicaid. In 2008, “the federal and state governments spent $603 million on births resulting from unintended pregnancies; of this, $217 million (36%) was paid by the state.”

Therefore, it is crucial to address these gaps in North Carolina’s Contraceptive Equity law, thus expanding coverage for poor women and lifting the economic burden of unintended pregnancy from the state.