The Deficit Reduction Act of 2005, which just came into effect this year, was responsible for the dramatic rise in price. It’s basically a Medicaid reform bill—according to a White House “fact sheet,” the main purpose of the bill is to reduce growth in mandatory spending programs like Medicare, Medicaid, and Social Security “while ensuring that Americans who rely on these programs continue to get needed care.”

But the drastic increase in the price of birth control means that many of us can no longer afford it. Before the Deficit Reduction Act went into effect, drug companies sold certain prescription drugs at large discounts to colleges and other health care providers for a multitude of reasons. The drug companies didn’t have to calculate the discounts into the rebates they paid to states to participate in Medicaid. But now the drug companies have to pay more to the states to participate in Medicaid if they continue to sell drugs to colleges at a discount, thus reducing their incentive to sell discounted drugs (including birth control) to colleges—which means that, in the end, students are the ones who make up the difference.

Once the incentive was removed, things quickly changed for the worse. In late March the Associated Press reported that the prices of birth control pills at student health centers were doubling and tripling at campuses around the country.

This change came unexpectedly, and not many people understand why Dartmouth and other colleges stopped offering affordable birth control. Even for students with their own health insurance, the price of birth control still rises under the new bill. In addition, birth control prescriptions are now processed through insurance—which may stop many students from using the pill at all. Many students don’t want birth control showing up on an itemized statement that goes to their parents’ house.

The increased price and exposure of the prescription is likely to reduce the number of college women on the pill. Though condoms are highly effective when used consistently and correctly, college students don’t tend to do so. This increases the need for birth control as a secondary, and sometimes primary, method of pregnancy prevention—so any reduction in the number of women on the pill is a dangerous development. According to the American College Health Association’s Spring 2006 National College Health Assessment, 38 percent of sexually active college students rely on birth control pills as a method of pregnancy prevention.

The good news is that some states are taking the initiative to return negotiating power to clinics and offer more affordable birth control prices. Minnesota’s legislature enacted a law that would enable clinics to join together as cooperatives to negotiate bulk sales of prescription drugs. This could reduce the cost of birth control by as much as 50 percent.

The Bush administration and Congress are harming college-aged women, who are just trying to be responsible and practice safe sex. It could be that they simply don’t care, since they do have their own, outdated agenda when it comes to pre-marital sex. Other states should follow Minnesota’s lead and take action, but a better course would be for Congress to reverse course and ensure affordable access to contraception.

A version of this story originally appeared in the Dartmouth Free Press.

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