This school year, college students aren't just scrimping to afford textbooks and bus tickets—they're also digging deep to pay for birth control that has more than quadrupled in price since last year.

At Reed College, birth control has gone from $8 to $36 a month. At Lewis and Clark College, the health center now only provides two types of birth control, instead of six (they axed the most expensive options).

"It's a serious issue that needs to be fixed immediately," said Justine Spencer, college student and head of the Reed chapter of Vox: Voices for Planned Parenthood. "When students are faced with buying food and books, they won't be able to afford birth control."

The Reed chapter of Vox surveyed about 200 students and found many of them were no longer using birth control and were angry at the hike in prices.

Spencer helped organize a student demonstration at the end of October. A display table showed one packet of birth control next to its $36 equivalent in food—198 packages of Top Ramen noodles. The display was meant to drive home the choice college students—and uninsured women—were being forced to make.

The price increase is the result of President Bush's 2005 Deficit Reduction Act (DRA), a law designed to curtail federal spending, including the money spent on Medicare and Medicaid. The effect on the price of birth control was an unforeseen result: A provision of the DRA limited the ability of pharmaceutical companies to sell discounted drugs to prevent them from abusing state Medicare rebate programs. While some health care providers were exempt from this limitation, university clinics and some safety-net providers weren't.

However, because of the language in the DRA, Planned Parenthood in Oregon has been able to continue negotiating with pharmaceutical companies for low prices.

"We haven't been impacted by this," said Tess Fields, field manager of Planned Parenthood of the Columbia/Willamette. "We're standing up for the university health centers in Oregon that can't negotiate nominal pricing for birth control."

Since January, when the DRA went into effect, Planned Parenthood has been trying to solve the problem via a legislative fix. But Bush's determination to veto much of the legislation passed by the Democrat-controlled Congress has frustrated these efforts.

"The Bush administration has had an opportunity to fix this problem and they have chosen not to," said Fields, "Therefore, Congress has to do it."

Earlier this month, Senators Barack Obama and Claire McCaskill proposed a piece of stand-alone legislature entitled the Prevention Through Affordable Access Act, which would restore access to discounted drugs for university and safety-net clinics. The act is co-sponsored by 15 senators, including Hillary Clinton and Oregon's Ron Wyden.

Even though the Affordable Access Act is a step in the right direction, Planned Parenthood is concerned the legislation will be shouldered aside by bigger issues.

"It's just about priorities," said Fields. "There's not an intentional stall, but we're in the middle of a war—there are big budget fights. That's why we're trying to raise awareness of the impact of this issue."

Oregon Senator Gordon Smith has not supported the Affordable Access Act, even though he sits on the financial committee that was responsible for the DRA problem in the first place.

"That [Affordable Access] bill's probably not going to go anywhere," said Kimberly Collins, a spokesperson for Smith. According to Collins, Smith won't co-sponsor the act because the finance committee is working on an improvement package for Medicare that will include affordable access to birth control.

However, these political maneuvers aren't changing the current financial realities for college students. If the Prevention Through Affordable Access Act isn't passed, 200 Planned Parenthood clinics, university clinics, and thousands of women across the country will continue to face difficult decisions about birth control and financial priorities.

For example, in Oregon, students who can no longer afford to buy birth control at their universities can consider another, more controversial short-term option: clinical trials.

"Clinical trials are a good way for women to access the health care system," said Dr. Heidi Printz, division manager of the Women's Health Research Unit at OHSU. "Through a research environment, we basically work to further the services Planned Parenthood provides."

The ethical implications of uninsured women facing a choice of no health care, or accessing health care through a clinical trial, have long been debated. However, Printz asserts that birth control clinical trials are closely regulated and often use birth control that has already been approved by the Food and Drug Administration.