Gen Z is coming of age in a nation that still denies contraception. Despite federal guarantees, loopholes and refusal laws keep reproductive care uncertain nationwide.
Everyone has a defining memory that shapes how they come to see the world. For me, a Gen Z born in 2007, it was kneeling in front of the television, eyes fixed on the screen, watching Barack Obama take the oath of office.
We are the change we seek! Yes we can! Healthcare for all! These are the phrases I grew up on, the slogans that convinced me collective activism could transform the principles of equality into reality. Within my soul resided the belief that justice would continue to march forward and that rights won would remain intact.
However, more than a decade after the Affordable Care Act (ACA) promised access to birth control, I found myself at the pharmacy counter, forced to walk away without it. My insurance refused to cover the pills I need to regulate my hormones, to prevent a third surgery for cystic breasts and to alleviate excruciating period pain. That was my first confrontation with a false promise—but hardly the first loss of what I considered a secure right.
I will turn 18 shortly, and watching the idealism of my youth quickly unravel is terrifying.
Although the ACA guarantees cost-free access to birth control, that promise remains elusive and unfulfilled for millions of women who continue to encounter systemic barriers to obtaining contraceptives. Now, as the Republican budget plan aims to end Medicaid reimbursements to providers like Planned Parenthood, and bills like the Right to Contraception Act get leveraged for partisan showmanship, contraceptive access is being stripped away from the people who need it. The gap between our legal rights and lived reality is ever widening.
In theory, the ACA requires most health insurance plans to cover all FDA-approved contraceptive methods without any cost-sharing. In reality, that promise breaks down at the pharmacy counter—whether on account of delays, rejections, cost-sharing and a host of exceptions. An October 2022 report from the House Committee on Oversight and Reform found that 40 percent of exception requests were denied by insurers and pharmacy benefit managers between 2015 and 2021. A legal guarantee means little when insurers can exploit loopholes, drag out exceptions processes or quietly impose costs that push contraception out of reach.
In addition, states are eagerly stepping in to empower pharmacists to decide who does not get contraception. As of July 2025, Arizona, Arkansas, Georgia, Idaho, Mississippi and South Dakota all have laws explicitly allowing pharmacies or pharmacists to refuse to fill prescriptions on the basis of personal belief. Meanwhile, Tennessee’s recently passed Medical Ethics Defense Act, one of the most sweeping refusal laws to date, permits pharmacists to deny birth control outright. These laws disproportionately harm women of color, LGBTQ+ individuals, low-income patients and people in “pharmacy deserts.”
Access to contraception is also increasingly entangled with attempts to target abortion. The “Big Beautiful Bill” provision that restricts federal funding for Planned Parenthood and other healthcare nonprofits, has already shuttered centers across the country which use Medicaid funds primarily for contraceptive care. These centers often serve as the only affordable healthcare option for low-income and underserved patients.
Even before the advent of the current Trump administration, politicians too often treated reproductive rights as a mere bargaining chip. When Senate Republicans blocked the Right to Contraception Act in 2024, then-Senate Majority Leader Chuck Schumer stated that Democrats were “putting reproductive freedoms front and center before this chamber, so that the American people can see for themselves who will stand up to defend their fundamental liberties.” Fully aware the bill stood little chance in a polarized, pre-election climate, they introduced it anyway as an election-year ploy to spotlight the divide between the parties and position it as a winning issue with independents and swing voters.
Quite frankly, this soon-to-be voter was not impressed. Refusal to treat access to contraception as an urgent cause in its own right is a devastating betrayal–of campaign promises, of ideals and of commitment to democracy. It is long past time to fight for something more enduring.
Codifying the universal right to contraception into law is urgent. So too is ensuring those rights are enforced and that birth control is accessible to all, not just those with privilege or proximity to care. Advocating for the passage of the Access to Birth Control Act, recently reintroduced by Senators Patty Murray and Cory Booker, is one necessary step toward closing the gap. It would guarantee patients timely, harassment-free access to their preferred form of contraception at pharmacies nationwide and hold pharmacies legally accountable if they refuse, delay or intimidate patients seeking birth control.
Until equitable access is treated as inseparable from the right itself, reproductive freedom will remain uneven, uncertain and easily undermined.
Great Job Azuri Brown & the Team @ Ms. Magazine Source link for sharing this story.
