Despite the myriad benefits and uses for contraceptives, access remains under threat. There’s a very real fear that women’s rights to contraception will be rolled back after Supreme Court Justice Clarence Thomas recently wrote that previous rulings on contraception should be reconsidered.“In the wake of Roe v. Wade being overturned, it makes me nervous about the future of access to birth control,” Luders-Manuel said. “It makes me nervous for people with PMDD, because for so many of us, it is such an important medication.”Twelve states allow some HCPs to restrict contraception-related services. Even now, many women, especially low-income women, live in areas called contraceptive deserts. “One barrier to access is that women can’t get to a provider, either because there are no providers near them at all, or there’s no provider near them who can offer the kind of birth control that they want,” said Mara Gandal-Powers, director of birth control access at the National Women’s Law Center. “We also see out-of-pocket costs [being] a huge barrier for people, whether that’s because they are uninsured, they can’t use their insurance or their health plan is not complying with the Affordable Care Act.”Under the Act, health insurance providers must provide coverage, without any cost-sharing requirements, for at least 18 FDA-approved contraceptive methods. Health insurance providers can’t require a patient to use a contraceptive method that differs from what their HCP recommends, although they can require a patient to use a generic version of the same method. While the ACA only references contraception as a form of preventive care, federal guidance suggests that insurance companies must defer to what HCPs deem medically necessary.Unfortunately, not all health insurance providers comply.