There should be universal free LARC

LARC (Long Activer Reversible Contraceptives) are highly effective. It seems to me past time for the US Federal Government to pay for contraceptives (all types not just the device of pharmaceutical but also cost of care from the prescribing physician if required) for everyone who wants them (including Elon Musk if he changes his mind about reproducing as much as possible — no means test).

I think that Joe Biden and Nancy Pelosi should make a big deal of this for two reasons. FIrst there is very strong evidence that it is very excellent policy. Partly financed by a very rich actuall effective altruist, Colorado tried this with dramatic results


This initiative empowered thousands of Colorado women to choose when and whether to start a family.

Thanks in large part to the Colorado Family Planning Initiative:

  • Teen birth rate was nearly cut in half.
  • Teen abortion rate was nearly cut in half.
  • Births to women without a high school education fell 38 percent.
  • Second and higher order births to teens were cut by 57 percent.
  • Birth rate among young women ages 20-24 was cut by 20 percent.
  • Average age of first birth increased by 1.2 years among all women.
  • Rapid repeat births declined by 12 percent among all women.
  • Costs avoided: $66.1-$69.6 million.

That’s pretty good for a simple policy initiative. The program ended in 2014 (I forget why). The beneficial effects did not end (recall “long acting”).

“Although the intervention reached people across the state, the outcomes we report here focus on adolescents and young adults. Statewide, large declines were seen in the adolescent birthrate (from 11.2 per 1000 in 2008 to 3.9 per 1000 in 2019), the adolescent abortion rate (from 39.6 per 1000 in 2008 to 13.5 per 1000 in 2019), and the number of second-order or higher births to adolescents (from 1258 in 2008 to 290 in 2019). We did not identify any adverse effects during the CFPI or during the five-year follow-up period.”

Notably, this is a rare preventive medicine effort which will pay for itself (or close). In particular, uninsured people who have trouble with access to contraceptives (in spite of Obamacare) will often need a whole lot of assistance in case of an unwanted pregnancy (and get a smaller amount of assistance than is needed and suffer as will the children).

I think it is also good politics. For one thing, post Dodd focus on reproductive health is good for Democrats (a way to get young people to actually vote ?) . The most militant anti-abortion activists are also anti birth control (often calling all sorts of contraceptives abortifacients). Their position on abortion is very unpopular and poisonous as cyanide for Republicans. Their position on contraceptives is more like nerve gas. Republicans have blocked passage of the Right to Contraception Act. This amounts to attempting political suicide, but they need help from Democrats who draw attention to the issue to achieve self destruction.

Note also safe legal and *rare* “Teen abortion rate was nearly cut in half.” The anti sex lobby can’t pretend that they only oppose abortion if Dmocrats focus on the issue of free access to LARC. This whole debate is political gold for the Democrats, so anything which draws attention to it is good politics.