Sarah Leonard

n November 2007, the members of the Columbia University College Democrats’ Activist Council made a decision to focus on reproductive health issues. They quickly discovered a problem that has been frustrating college students across the country. With little warning, the prices of contraceptives, formerly subsidized for college clinics, had shot upwards with little warning, drastically changing healthcare costs for some female students. The effects were so far-reaching and widely felt that the Columbia Spectator and the New York Times alike began reporting the issue.

The students launched an investigation into the problem and began to plan for activism in support of affordable birth control. The group was immediately drawn to the issue not only because of its immediate practical concerns, explained Jenna Hovel BC 2010, a Lead Activist on the council, “but also because the issue is connected to core progressive beliefs about working for affordable access to medication and protecting women’s reproductive health.” What the students found in their research was a tangled mess of national and university bureaucracy, a maze of hidden partisan politics, and the activist potential to push Columbia University toward providing better student healthcare.

The nationwide change in birth control prices was a direct result of the 2005 Deficit Reduction Act, a piece of legislation that the White House says “restrains Federal spending and leaves more money in the hands of the American people.” A section of the bill was altered to prevent abuses of a system that occurred when drug companies who were given exemptions from Medicaid pricing rules then provided discounted drugs to college clinics and community health clinics. According to the New York Times, some such companies had engaged in possible abuses such as “trading those big discounts for product promotion in hospitals.” The rewriting that was meant to address these abuses also inadvertently disqualified these clinics as beneficiaries of the discount system.

Few have suggested that this omission was anything more than a legislative typo, although as Anna Scaife BC 2011, who has been heavily involved in the Activist Council’s efforts, notes, “It’s hard to imagine that absolutely no one along the way noticed.” Intentional or no, as a result of the faulty legislation, colleges across the country scrambled to stockpile contraceptives at the discounted price.

As the effects began to ripple across the country, concerned groups took up the cause. The American College Health Association has responded with action alerts aimed at rallying its members to call Congress in support of remedial legislation. The remedial legislation that has now been put forth is H.R. 4054 in the House of Representatives and S. 2357 in the Senate, sponsored by New York Congressman Joseph Crowley, and Senators Barack Obama (D-IL) and Claire McCaskill (D-MO) respectively. At Columbia University, in preparation for a day of activism in support of the legislation, the Lead Activists sought information from Columbia and Barnard administrators through meetings and over e-mail, since they had been able to glean substantial information from the official responses. “Columbia University Health Services sent us a pretty flimsy press release, but that was all the information they would supply to us,” says Mara Richard, a Lead. The press release expressed support for women’s health in general terms without directly addressing the changes caused by the Deficit Reduction Act.

The Dems reached out to students as well. On December 6, 2007, the Activist Council held a combined educational and activist event on Low Plaza designed to inform students about the changes brought about by the Deficit Reduction Act and to gather signatures for a petition to bring to Health Services. Students were also able to call their legislators on Capital Hill in support of the remedial legislation. Many students seemed shocked to hear about the change and readily signed the petition; after a few hours there were 102 signatures. When Prishantha Dunstan, ESC Vice-President for Policy, approached the table to discuss the issue, a campus coalit i on began to form.

As Columbia and Barnard students promoted the cause of affordable birth control, campuses across the nation were working towards the same goals on their own campuses. While some schools acted immediately to insulate their students from price changes by stockpiling drugs or providing subsidies, others needed the pressure of the student body. Students in Utah and Montana protested the price hike, and student newspapers from the Harvard Crimson to the Stanford Daily called for change and emphasized the pressure that the new legislation would bring to bear on students. A Crimson Editorial noted on November 28 that “For cash-strapped students, this price increase amounts to a serious burden, one that makes it substantially more difficult for them to afford necessary contraception and is therefore a hindrance to practicing safe sex.” In October, Columbia University’s Spectator published an editorial insisting that “Columbia must use its influence to enact change and ensure that all students have access to contraception.”

Vocal students seemed largely on the same page in terms of their belief in access to contraceptives, but navigating school bureaucracies, and affecting Congress, would prove difficult. In the House of Representatives, Congressman Crowley’s bill was referred to the House Committee on Energy and Commerce, where it promptly ceased to move forward in any discernible fashion. The Senate Bill was similarly referred to the Committee on Finance. Despite efforts by the CU College Democrats, it was difficult to tell when the bills might appear on the floor for a vote by Congress or what actions might help push the legislation forward. Despite no apparent public opposition to the bills and the fact that Democrats chaired both committees, the bills languished in committee as the changes to the Deficit Reduction Act began to take effect.

As Winter Break ended and Congress failed to act, the Activ- ist Council invited numerous Columbia and Barnard organizations to take part in a discussion about pressuring Columbia University to help students with increased costs. Barnard College, by maintaining a dispensary, had so far avoided being affected by the loss of subsidized medications. The exact effects that the Act was having at Columbia were unclear and, given the personal nature of birth control, the activists found it difficult to compile personal stories on campus.

Out of this meeting emerged the non-partisan and informal coalition, the Campaign for Cheaper Birth Control, composed of groups dedicated to ensuring affordable birth control at Columbia; Columbia College Student Council, the Student Governing Association, Take Bac.k The Night, the Columbia ACLU, and Students for Choice all joined. CCSC immediately helped to draft a statement regarding birth control and sent it to all Columbia College Undergraduates. The release concluded that “Columbia must be aware of the negative consequences of its failure to act. Students who cannot afford the financial difficulty or would not like to ask their parents for the money would likely go without this basic necessity. It is not necessary to enumerate the many consequences this could have for our female students. Columbia must act to avoid such risks.”

Student opinion was coalescing and awareness was growing. The Lead Activists were finally granted a meeting with members of the Columbia Health Services administration and were informed that the Columbia clinic had in fact not been affected by the Deficit Reduction Act and, for users of the Columbia insurance plan, had maintained its three-tiered system of pricing oral contraception. According to this system, generic drugs were tier one and cost $10. Non-generics on the Preferred Drug List were $25. Brand name medications not on the Preferred Drug List were tier three and cost $40. But compared to the free contraception at Dartmouth, and $6 per month charge at Princeton, this hardly seemed adequate, especially for students in need of tier three drugs due to their reactions to certain hormones. The Campaign for Cheaper Birth Control is today continuing with its work to lower prices by meeting with administrators and gathering student signatures and support.

As students make steady gains at the college level, progress in Congress continues to crawl. According to Scaife, who met with legislative aides on a recent Smart Women Lead trip sponsored by Barnard, the bills have been held up largely due to Republican attempts to attach provisions to the remedial legislation that Democrats find unattractive, such as an amendment preventing potential future subsidization of Plan B (the “morning after pill”). Planned Parenthood’s aggressive support for the Democratic legislation has doubtless encouraged GOP distrust.

While there is no way to tell when Congress may fix its mistake, students have proven the power they can exert at the campus level. Health services posted new information on its website in response to student concerns that information on the topic was impossible to find. Discussions continue about reducing costs, and across the nation, students have forced change on their campuses that will be of tremendous benefit to women’s health. Columbia’s administration may be highly bureaucratic and difficult to penetrate, but progressive students are proving that it remains possible to bring about positive change by working with University staff.

At the national level, the opposite conclusion may be drawn. Despite overwhelming support and displays of activism by America’s students in favor of correcting the legislative error, the relevant bills have failed to move and Congress has allowed a typo to complicate healthcare for thousands of women who rely on campus and community clinics. Members of Congress ought to heed the needs of their young constituents, but tragically, on this issue, Congress has proven to be one bureaucracy the student voice simply cannot penetrate. With the resending cry for corrective action coming from campuses in every part of the country, members of Congress will have to act soon or defend denying, due to a congressional typo, a sensible, widely-supported healthcare benefit for young and low-income American women.