Are contraceptives unaffordable for female students at Georgetown Law?

Question

At a hearing before the House Democratic Steering and Policy Committee, Sandra Fluke said:

"Without insurance coverage, contraception, as you know, can cost a woman over $3,000 during law school. For a lot of students who, like me, are on public interest scholarships, that's practically an entire summer's salary. 40% of the female students at Georgetown Law reported to us that they struggled financially as a result of this policy."

Now this alone might not make her notable, since she is just a private citizen who testified at a single hearing during a Congressional recess, but a firestorm of controversy erupted when conservative radio host Rush Limbaugh called her a name. Additional, she has thrust herself into the public eye, most recently speaking at the Democratic National Convention, and is considered a poster child for the Democratic party.

Can contraception cost a woman over $3,000 during law school?

Do 40% of female students at Georgetown Law struggle financially to pay for contraceptives?

I know that these are two claims (and normally, they should be separated), but they are both highly related. Both are about the affordability of contraceptives to women in law school. The first question is technically true, it can cost $3,000. (Example: I could spend $1 million on transportation by purchasing a Bentley for each day of the week to take me to law school). This is really a question of if this claim is true, how much contraception would you have to use to spend $3,000, and is this a reasonable amount (i.e. see Bentley transportation). The second question is related to the first, and is a function of how much money it costs for contraceptives for women. Is $3,000 (assuming that is true) an amount of money that someone going to Georgetown Law school would struggle paying?

Answer 1

As there are two parts to this question, the answer will be broken into two parts; however, it should be noted that the question of affordability is subjective and depends on the person and that should be kept in mind.

Can contraception cost a woman over $3,000 during law school?

In general, in the United States, when a woman talks about contraception she is generally referring to some sort of oral contraceptive pill as opposed to supplying her partner with condoms.¹ Searching for pricing information indicates that the prices generally seem to range between $9 to $100 depending on the source. (1, 2, 3, 4, 5) Since that is a fairly extreme range and there can be medical reasons (e.g. side effects, medical conditions) for not prescribing some forms of oral contraceptive versus others. Furthermore, these numbers are actually quite important since the Student Heath Insurance at Georgetown University does not cover "medication to prevent permanency." Given that the J.D. program at Georgetown Law is a minimum of three years (six semesters) we will assume that the majority of students graduate in that time frame, thus:

# Based on lowest cost generic
$9/month * 12 months * 3 years = $324

# Based on highest cited monthly cost
$100/month * 12 months * 3 years = $3600

As you can see, the range is quite extreme and but, yes it can cost a woman over $3,000 to take oral contraceptives over the course of law school.

Do 40% of female students at Georgetown Law struggle financially to pay for contraceptives?

This is an extraordinarily hard question to answer without knowing where that number came and some Googling didn't show evidence of a student survey being conducted on campus so that number may be from an "informal survey" and a bias might be involved. At best we can attempt to draw some conclusions based upon speculation, based the projected annual cost of living of $23,635 for a Georgetown Law student.

Speaking subjectively, going to school full time generally means you are spending around eight hours a day either in class or studying with some of the higher achievers doing more and others doing less. However, eight hours gives us a fairly reasonable number to work with. Assuming that someone is really eager to try and ensure they keep their debt to a minimum they might be able to pick up close to 40 hours a week worth of part time work. The minimum wage in Washington D.C. is $8.25/hour. As such, a diligent worker picking up 40 hours a week and working the full 52 weeks in a year will manage to bring in around $17,160 gross which would give them about $14,215.76 net after taxes, or about $273.38 per week (single with one exemption in Washington, D.C. using this calculator). Given that the $14,215.76 net is less than the $23,635 projected annual cost of living it is reasonable to speculate that students might struggle.

Granted these numbers are very simplistic and do not take into account being paid more per hour, working summer internships at a higher rate, relocating when school is not in session, and so forth. Which leads us back to the original statement that the question that 40% of female students struggle financially is likely unanswerable without more information as to where that number came from.

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1. From a cultural standpoint, in the United States men are generally expected to supply the condoms and as such, would be excluded from a woman's budget rendering the question moot. However, as condoms are not fail proof and it is still possible to get pregnant when they are used correctly, oral contraceptive is quite often used by women in conjunction to the use of condoms.

Answer 2

Cost of Georgetown Law and contraceptives.

Since Fluke's claim is 40% of women struggle to pay for contraceptives over the course of law school, it is important to know what the cost of contraceptives would be compared to full-time students and part-time students. For this portion of the analysis, we will assume that the 40% of women who are struggling financially are spending $3,000 at law school on contraceptives (we will get to the validity of that claim later).

Students in the full-time program are expected to graduate at the end of three academic years, Students in the part-time program are expected to graduate within four academic years of being accepted. Living expenses are around $22,895/year. Full-time students (tuition) cost = $40,920/year, Full-time students (contraceptive) cost = $1000/year, Part-time students (tuition) cost = $33,500/year, Part-time students (contraceptive) cost = $750/year. Using these numbers:

• Full-time cost of contraceptives = 1.6% of total, 2.4% of tuition, 4.4% of living expenses.
• Part-time cost of contraceptives = 1.33% of total, 2.23% of tuition, 4.4% of living expenses.

The majority of students did not receive any scholarship money (557 of 1990 according to top-law-schools, only 9.9% according to lawschoolnumbers), and of those the majority received less than half tuition in aid. The median grant amount was $15,000 (FT), and $8,900 (PT). If 40% of women struggle financially to afford contraceptives, the best case scenario is, 239 women with no financial aid are struggling to pay $3,000 out of $191k over 3 years (1.6%), and the remaining students with a median $15,000 of financial aid are struggling to pay $3,000 out of $146k over 3 years (2.1%). $3,000 is a miniscule expense compared to the cost of graduating from Georgetown Law. It is highly unlikely that 40% of the total students at Georgetown Law are capable of paying $146k-$191k over a 3 year period, but are struggling to pay $3,000. Even if you only compare this expense to just tuition & fees, it only amounts to 3.1%. This is especially true when you take the cost of rising tuition&fees (page 6) into account, (2010-11), (2011-12), (2012-13).

 |2005-06|2006-07|2007-08|2008-09|2009-10|2010-11|2011-12|2012-13|
 +-------+-------+-------+-------+-------+-------+-------+-------+
 |$35,080|$37,220|$39,390|$42,065|$43,750|$45,105|$46,865|$48,835|

Over an 8 year period, tuition and fees have increased $13,755 (40%). The average increase over a 3-year period is $5,158 (not adjusted for inflation). This is nearly 60% more than the cost of contraception for women over a 3-year period that Sandra Fluke claimed a woman could spend.

What is the cost of contraceptives, could it really be $3,000 over 3-4 years?

The previous section, we know that Full-time students would spend on average $1000/year, and Part-time students would spend on average $750/year. The cost of different forms of birth control are:

Birth Control pill ($15-$50 at planned parenthood) = $9/month (Target, but Fluke didn't know) = $108/year (Target)

Depo-Provera ($35-$75+exam($20-$40)) = $55-$115/quarter = $220-$460/year

IUD ($500-$1,000) at PP = $175-$400/5-10 years according to American Pregnacy

The costs here aren't enough to account for the yearly expenses. IUDs are the most expensive, but dividing the cost over the life of the IUD means that it is cheaper than Depo-Provera. What if we include the cost of condoms as well. If we take the most expensive birth control (Depo-Provera), and figure out how much is left for condoms (PT student = $530-$290, FT student = $780-$540). This assumes that the woman's male partner never pays for condoms, and that the woman never receives free condoms from a local planned parenthood. According to the American Pregnancy Association, condoms cost:

• Condoms ($0.20-$2.50 each), or (free-$1 at Planned Parenthood)

With a little shopping around, and buying larger packs, condoms shouldn't cost too much. One experimenter found that the cost of two major brands in the large count boxes (24-36 each) was between $0.41-$0.79 (In large bulk sizes 1000 count, that cost could be reduced to $0.15-$0.16. This might come in handy, as you will see later on).

• Part-Time Low Estimate = $290/$0.79 = 367 condoms/year = 1 condoms/day.
• Part-Time High Estimate = $530/$0.41 = 1292 condoms/year = 3.5 condoms/day
• Full-Time Low Estimate = $540/$0.79 = 683 condoms/year = 1.87 condoms/day

• Full-Time High Estimate = $780/$0.41 = 1902 condoms/year = 5.2 condoms/day

• Super 1000 bulk buy = PT student (5-9/day) or FT student (9-13 condoms/day)

With a little shopping around, Sandra Fluke and other Georgetown Law students would be able to have sex 5-13 times/day. If you plan to have sex this often, it would make sense to by in the 1000 count bulk, instead of struggling to pay for such small (24-36 count) quantities. Condoms have a 3-5-year shelf life. How does this compare to the normal sex life of the average woman? The National Survey of Sexual Health and Behavior has these numbers for women who have sex 4 or more times per week (age range chosen because it listed the highest percentages):

|Woman    |18-24|25-29|
+---------+-----+-----+
|Single   | 4.9%|10.1%|
|Partnered| 7.5%|12.8%|
|Married  |23.5%| 2.0%|

The vast majority (76%-90%) of women are only having sex 3 or fewer times per week.

In Conclusion

To spend $3,000 on birth control over 3-4 years of law school, a woman would need to use a combined birth control, and condoms to protect themselves. If they shop around, and buy condoms in bulk, If they bought their condoms in bulk, they can have sex between 5-13 times per day. If they use the birth control pill instead of the shot, they can double those numbers. And if they requested that their partners buy condoms half the time, they can double those numbers again.

It is highly unlikely that 40% of Georgetown Law students are struggling to pay for birth control, unless they differ vastly with respect to most 18-29 year olds. For a woman to use $3000 over the course of 3-4 years would require her to have sex an unusual amount. For this reason, it is highly unlikely that it can cost $3000 for a woman at Georgetown Law to buy contraceptives.