It's looking like women may have to go back to paying out-of-pocket for contraception if Obamacare gets gutted.
This article originally appeared on Money.com.
Senate Republicans took the first step toward repealing the Affordable Care Act during Thursday's "vote-a-rama"—and while voting on a budget plan that would help dismantle Obamacare, the GOP-controlled Senate rejected an amendment that would have required insurance companies to continue to cover birth control.
Sen. Kristen Gillibrand had introduced the amendment, aiming to preserve a few ACA provisions tied to women's health: Current rules prohibit insurers from charging women more for coverage based on gender, or using pregnancy as a pre-existing condition to deny coverage, and require coverage of of birth control, mammograms, and cancer screenings without a co-pay. Republicans voted it down.
Of course, Republicans have not presented a replacement plan for Obamacare, so it is impossible to say if birth control will continue to be covered. Until the law is officially repealed—and there's still a long way to go—you can still receive prescribed contraceptives without a co-pay. (For more, read What Women Should Know About Health Care Under Trump.)
Roughly 55 million women now receive contraceptives with no out-of-pocket costs, according to the National Women's Law Center. And birth control costs can be significant: A 2015 study found that "the ACA is saving the average pill user $255 per year, and the average woman receiving an IUD is saving $248."
Indeed, as MONEY has reported in the past, new birth control coverage is a key factor driving down average out-of-pocket spending on prescription drugs. According to a report from the Kaiser Family Foundation, "oral contraceptive pills account for 63% of the drop in average out-of-pocket spending on retail drugs since 2012."
Some state legislatures, including New York's, have introduced measures to require insurers to cover birth control with no co-pay if Obamacare is indeed repealed and the benefit is not included in whatever new plan is passed. California, Maryland, Vermont, and Illinois have had similar state laws in place since 2014, according to Reuters.