Family Planning and the Affordable Care Act: Lessons Learned from New York City Community Health Centers

The Affordable Care Act (ACA) has changed the face of healthcare in the United States. In New York City, thanks to the large expansion of Medicaid and availability of subsidies, many people now have health insurance and access to quality healthcare for the first time in their lives. One major change that was supposed to occur with the role out of the ACA was access to contraception with no copay. 

The ACA states that companies must provide generic contraception with no copay, or that they must provide brand name contraception with no copay when no alternative is available. However, a combination of poor training and coordination within insurance companies and community health clinics, coupled with a lack of consumer awareness has meant that many people are still being asked to pay a copay for their contraception. This lack of coordination and consumer awareness has left many women unable to access their contraception of choice, leaving them little option but to turn to safety net providers. The removal of this barrier has the potential to make reproductive health services much more accessible, especially for the most vulnerable, low-income population, but in practice, it has not been this simple.

Taking a few case studies from community health centers in the boroughs of New York City, this paper highlights lessons learned from the ACA role out and its impact on access to family planning services and offers lessons learned and discusses potential solutions.