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The IUD business is booming in the age of Trump.
At least 134,285 women have seen a doctor for an IUD prescription or insertion since Donald Trump was elected president, a 16 percent increase from the year before, according to data from Athenahealth. The number spiked immediately following Trump's election and fluctuated in the year after as he and Congress tried to repeal the Affordable Care Act.
The law, commonly known as Obamacare, mandates insurers cover the cost of contraceptives, including intrauterine devices, or IUDs. The birth control method is considered to be 99 percent effective and involves the insertion of a t-shaped piece of plastic into the uterus to prevent pregnancy. It can remain in place for years.
Obamacare made IUDs accessible to women who may not have otherwise been able to pay the upfront fee of about $1,000 for the device. Trump and Congressional Republicans vowed to repeal and replace the legislation and tried multiple times to do so, though unsuccessfully.
January 2017, the month Trump was inaugurated, saw the largest year-over-year increase of 38 percent, according to Athenahealth data of more than 2,200 practices providing contraceptive management to more than 1.5 million patients.
March, the month the House unveiled its first repeal-and-replace plan, saw the most insertions and prescriptions.
Some months saw hardly any growth compared with the previous year, while others posted sharp increases. Those variations tended to mirror the twists of the roller coaster that was trying to repeal and replace Obamacare.
"There's an analytic judgment making there because we didn't do any direct survey, so we're not sure it's conclusive," said Josh Gray, vice president of Athenaresearch, the research unit of Athenahealth. "But in my opinion, it strongly suggests an obviously rational anxiety women were feeling about the rollback of the ACA translating in increases in IUD procedures."
Bayer makes three of the five IUDs that are approved by the U.S. Food and Drug Administration. In the first quarter of 2017, sales of Bayer's U.S. IUD category grew 30 percent year-over-year, excluding the effects of foreign exchange. Growth slowed to 4.8 percent in the second quarter and 2.2 percent in the third quarter.
A spokeswoman for Bayer declined to comment, citing company policy against discussing sales information.
Adam Jacobs, medical director of Mount Sinai Health System's division of family planning, saw an uptick after the election. He remembers some patients coming in and saying they had been considering getting an IUD and weren't completely sure beforehand but figured they ought to do it before they might lose coverage.
However, Jacobs notes that IUD insertions were already on the rise before Trump entered the political scene. More doctors recommend IUDs as the standard contraceptive because they last longer and are shown to be more effective, he said.
"The combination of it was growing anyway from even before President Trump's election made it where it was like, 'Oh my god, if I don't get this there's the ultimate possibility I'll lose my insurance or lose the ability for a co-pay' made it into sort of a fear factor," he said.
The uncertainty convinced Sarah, a 26-year-old business consultant in Columbus, Ohio, it was time to get an IUD. She had been using the NuvaRing but decided to switch to the Skyla IUD in November after pondering the idea for a year.
Since Trump's election, Sarah said she worried the contraceptive mandate would be repealed and that she wouldn't be able to afford her current form of birth control. With the IUD, she thought, she would at least have three years of certainty.
"At any point, depending on how things go with health care for women, easily the birth control mandate could be removed and that could make it financially difficult to access birth control. So I thought it might be smart for me to get an IUD now while it's 100 percent covered by insurance, thinking if it doesn't work out I can go back to what I was on before," said Sarah, who asked for her last name to be withheld.
One year into Trump's presidency, the administration has tried to rollback the ACA's birth control mandate. It expanded a rule that made more entities exempt from providing plans that cover contraceptives without a copayment on the grounds of religion. Two district courts blocked the rule in December.
Attempts to repeal and replace Obamacare were unsuccessful last year, but with the tax law passed, the debate could pick up again.