This could have devastating consequences for patients. Earlier this year, I saw a patient with a "grandfathered plan," meaning that it was exempt from the contraceptive mandate. She desperately wanted an IUD, as her birth control pills had failed her and she had ended up with an unintended pregnancy. However, she could not afford the upfront cost of an IUD insertion and went home with the same method that had failed her previously because it would cost her only $15 per month. By the end of five years, this less effective method will actually cost her more than the IUD she wanted all along. And if the pills fail again, the insurance company that wouldn't pay for her IUD may end up paying for a pregnancy instead, which will costs many times more.