Free birth control would increase the occurrence of risky sexual behaviour

The argument

One argument against making birth control free holds that removing the cost would encourage riskier sexual behaviour by lowering one of the perceived deterrents to it. On this view, the price and effort of obtaining contraception act as a small friction that prompts people to weigh their choices, and eliminating that friction — making contraception free and frictionless — signals that sex carries fewer consequences and may lead some to behave more casually or recklessly than they otherwise would. The concern is an instance of moral hazard: when the perceived cost of a risk is reduced, people may take on more of it. Proponents extend the worry specifically to sexually transmitted infections. Much free or heavily promoted contraception, such as the pill or implants, prevents pregnancy but offers no protection against STIs, which require barrier methods such as condoms. If easy, cost-free access to pregnancy prevention encourages more frequent or less cautious sexual activity, the argument runs, it could paradoxically increase the spread of infections by removing the pregnancy deterrent while doing nothing to guard against disease. More partners and more casual encounters, enabled by the sense that the main risk has been neutralised, could raise the overall level of sexual risk-taking in a population. From this standpoint, a policy intended to improve health might have unintended behavioural consequences that offset its benefits, and the question of access cannot be separated from how access shapes conduct. Making contraception entirely free, proponents argue, is not the simple good it appears, because it may alter incentives in ways that increase risky behaviour and its harms. Because free birth control could increase the occurrence of risky sexual behaviour, this argument holds, birth control should not be free.

Premises

Counter-arguments

Critics answer that the moral-hazard prediction is testable, and programmes that provide contraception at no cost — including large trials of free long-acting methods — have generally been followed by falls in unintended pregnancy and abortion rather than surges in reckless behaviour. Cost is a poor behavioural deterrent because it falls hardest on those least able to pay, not on the reckless, and demand for sex is largely inelastic to the price of a pill. On sexually transmitted infections the premise cuts the other way: free-contraception services typically bundle testing, counselling and condoms, so removing cost expands precisely the screening and barrier-method access that reduces transmission.

Rejecting the premises

[Rejecting P1] Contraceptive cost is not a meaningful friction on whether people have sex; it mainly determines whether the sex they already have is protected. [Rejecting P2] The moral-hazard inference is empirical, and free-contraception programmes have tended to lower unintended pregnancy and abortion rather than raise risk-taking. [Rejecting P3] Services that provide free contraception usually also offer condoms, STI testing and counselling, so they can reduce rather than raise infection rates.