Contraceptive Equity Fund

All Women Deserve Access to Birth Control: Supporting Women in Need to Get the Birth Control Right for Them

More than 19 million women eligible for publicly funded contraception live in contraceptive deserts – or counties in which there is not reasonable access to the full range of contraceptive methods. Further, an estimated 11.2 million women (age 19-64) in the U.S. still lack access to any form of health insurance—and consequently—no- or low-cost contraception. These grave statistics mean that millions of women in the U.S. – and disproportionately low-income women, women of color, and immigrant women – are put in the difficult circumstance of having to not only navigate direct cost barriers to contraception, but also challenges such as extra transportation costs, child care costs, and unpaid time off work. Birth control is basic health care and all women deserve to access the birth control method right for them because it gives them the power to decide if, when and under what circumstances to get pregnant.

No woman should have to decide between feeding herself or her family and accessing birth control. That is why we are launching a Contraceptive Equity Fund (CEF) to ensure that ALL women have access to the birth control method right for them. We will host the CEF on Bedsider.org, a proven digital birth control information and access network that already reaches 6.25M users per year. The CEF on Bedsider will offer women living at up to 250% of the federal poverty level access to:   

• Gas cards, shared ride vouchers, or other transportation offsets so that they can travel safely to necessary appointments.
• Reimbursement for direct costs of contraception that are not covered by insurance. Reduced-cost telemedicine solutions will also be offered.
• Reimbursement for child care and unpaid time off to make appointments will also be offered.  

Birth control has changed the game for women. Since it was made legally available to all women in the United States, we have seen the first female CEOs of Fortune 500 companies and a doubling of the percentage of women who complete their college educations. Bloomberg Businessweek has called contraception one of the most transformational developments in the business sector in the last 85 years. One-third of wage gains made by women since the 1960s are the result of access to oral contraceptives. But progress is not victory. There are millions of women in the U.S. who do not have equitable access to the opportunity that birth control offers.  The Contraceptive Equity Fund will help ensure all women—no matter who they are or where they live—have the opportunity to pursue the future they want, realize their full possibility, and follow their intentions. 

The CEF is the first private online fund that tackles the multitude of barriers to contraceptive access. CEF will be hosted by Bedsider, a digital intervention proven to reduce unplanned pregnancy reaching more than 6.25 million users annually. This will allow us to leverage an existing state of the art platform to address equitable access to birth control – a service so vital to millions of women. CEF’s theory of change draws on data that indicate women are more likely to use contraception if cost barriers are removed. CEF is innovative due to its service breadth, cost effectiveness, and scalability. 

Hosting CEF on Bedsider will ensure accessibility and the possibility of geo-targeting those most in need. We will leverage Bedsider’s social media channels for promotion and to generate “pay it forward” support from more affluent Bedsider users. Further, our solution requires a platform that enables seamless interactions among a diverse set of users: patients, ride-share providers, child care providers, and health care providers. Users will need to exchange and store personal information securely, Bedsider will need to accommodate integrations with existing service provider systems and/or APIs, and we will need to identify an automated workflow to validate patient eligibility. 

Our goal in the next 12 months is to launch the CEF. Success will be increased contraceptive use among women seeking to avoid pregnancy. We’ll measure impact based on intent, uptake, and consistent use of contraception. We’ll measure quality by shifts in the belief that CEF supports access to contraception and quality of experience. We’ll measure public cost savings, using our proprietary formula for public costs saved, and local clinic savings due to fewer missed appointments. Increased capacity will be measured by CEF uptake (goal: 3,000+ women/yr.) and increased local investment. We’ll monitor annual progress for all baseline measures.

CEF is designed for scale, and our vision is to expand CEF across the US in the next 3 - 5 years. Integrating CEF into Bedsider allows us to customize CEF benefits for differing market needs while leveraging our already robust functionality, audience, and content. CEF market parameters will be based on local partner and consumer feedback. Bedsider/CEF API will be shared with partners, as appropriate. We are in discussions with several regions about piloting and intensive push of the CEF, and we will scale further based on market viability/readiness and apply lessons learned from earlier sites to continually improve. 

We anticipate using social media, SEO, and word-of-mouth to reach our users. Our staff has strong experience with social marketing for behavior change, which we will use to drive our target audience in specific geographic locations to CEF using low-cost digital advertising. For word-of-mouth marketing, we anticipate leveraging Bedsider.org and on-the-ground partners, giving us a reach of millions. We are committed to the human-centered design process and have had our target audience guide CEF design, which will foster user retention. Through focus groups, we know our target audience is interested in CEF and is eager to use it. 

Although our solution is currently in the prototype phase, we anticipate serving those women most affected by unplanned pregnancy: women of color, low income women, and immigrant women ages 18 – 29. These women are most likely to be uninsured and lack access to publicly funded contraception. CEF will connect women in need (as determined by poverty level/wage analysis) to local services, provide reimbursement and vouchers to enable access to contraceptive services, and ultimately help them have the power to decide if, when, and under what circumstances to get pregnant. 

Our goal is to serve 3,000+ women in need/year and help them plan for pregnancy. Women will receive reimbursement, vouchers, or other support to access the contraception of their choice. Direct cost reimbursement, transportation, and child care are priority areas, which our focus group research reaffirmed. For example, one woman discussed the effect of transportation barriers on her health: “I don’t have a car so, transportation is hard. I haven’t been [to a doctor] in a bit.” Last, strong data support our theory of change that women are more likely to use contraception if cost barriers are removed. 

Our team excels in innovation, fundraising, strategic partnership, digital solutions, audience engagement, and measurement necessary for CEF success. All have a passion for ending unplanned pregnancy and using the voice of our audiences to guide their work. Chief Executive Officer Ginny Ehrlich has started two national health initiatives that scaled to reach millions of young people. Chief Program Officer Gillian Sealy has overseen multiple national efforts to close disparity gaps in preventable disease. Senior Director Jennifer Johnsen spent 17 years at PPFA as the Director of Health Information, and has deep expertise in digital interventions. 

When CEF launches, we will add a “pay it forward” campaign via Bedsider to enlist its 800K+/month users in supporting other women. We will also offer this campaign to our partners with consumer reach. Given potential public savings, we will seek support from national, state, and local public entities that benefit from the ROI once the impact of CEF is demonstrated. We will recruit diverse investors to support the national CEF infrastructure and scale to new regions over time. CEF has funding and/or in-kind support from one foundation and five telemedicine companies, and leverages Bedsider funding from two foundations. We will continue to actively fundraise from diverse sources, including telemedicine companies, pharmaceutical companies, healthcare providers, national/regional foundations, and individuals. Our exit plan will be to phase down benefits to women over time, but to maintain the robust content and tools offered by Bedsider.

We are applying to Solve to build relationships with Solve advisers and other Solve members. We are hoping to get guidance, feedback, and information on best practices and lessons learned from those that have been through the process of developing a technology-oriented healthcare solution. There is no better place than MIT to do so—as we would also benefit from access to some of the world’s finest academics and experts. 

Key barriers for our solution to succeed include having our users feel comfortable with sharing confidential information on a digital platform, and ensuring rapid spread and scale. Building a community of other Solve members that have grappled with similar challenges that fall at the intersection of technology and healthcare would allow us to glean best practices, lessons learned, and get support as we determine how to optimize our solution for the user while also optimizing for scalability.