Birth Control

Over-the-Counter Birth Control Garners More Republican Support

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M.Markus/Flickr

In the topsy-turvy world of mainstream feminism à la 2014, ending the prescription-only status of birth control pills would actually decrease their accessibility. Meanwhile it's largely conservative, male politicians calling for the pill to be sold over-the-counter. This week Thom Tillis, a Republican running for the U.S. Senate in North Carolina, became the latest to vocalize his support. 

"I think over-the-counter oral contraception should be available without a prescription," said Tillis in a Wednesday debate with Democratic Sen. Kay Hagan. "If you do those kinds of things, you will actually increase the access and reduce the barriers for having more options for women for contraception." 

Tillis joins the ranks of  Republicans Ed Gillespie (running for a U.S. Senate seat in Virginia), Mike McFadden (running against Democratic Sen. Al Franken in Minnesota), Louisiana Gov. Bobby Jindal, and Colorado Rep. Cory Gardner. Many have accused these men of using support for over-the-counter birth control as a cheap ploy to win over women voters. That seems entirely likely, and also entirely okay, to me. Politicians suddenly discover their support for all sorts of policies when it proves politically advantageous to do so. If it's good policy that they've come around to, I don't really care what got them there. 

And making birth control pills more widely available is good policy. All but a small segment of social conservatives agree that increasing people's access to safe, affordable contraception can cut down on unwanted pregnancies and, in doing so, a host of other societal ills as well. The trouble now arises when we try to agree on what "increasing access" means. 

As recently as a few years ago, it seemed like most prominent feminists supported over-the-counter sales of birth control. They cheered when the American College of Obstetricians and Gynecologists announced its support. ANd when the U.S. Food and Drug Administration (FDA) was considering making emergency contraception Plan B non-prescription (which it ultimately did), many wrote in favor of not just this but scrapping the prescription status of all birth control pills. Here's Feminist Majority Foundation President (and Ms. publisher) Eleanor Smeal in 2011

Women must not be forced to jump unnecessary hurdles to obtain safe and effective contraception. Men and boys of all ages can obtain condoms easily, without interference from any governmental authority. Women and girls deserve equal treatment and respect, at the minimum.

But "Obamacare has changed the terms of the debate," as the Los Angeles Times put it. Now some feminist activists and writers say no-copay contraception covered by insurance is the one true way improve access. Over-the-counter birth control is no longer "accessible" enough because people would have to pay on their own. 

There are a lot of strange assumptions baked into this sort of opposition. The first is that over-the-counter birth control necessarily takes the place of insurance coverage for birth conrol pills. That may be what some pushing for OTC birth control wish, but there's no reason the two things have to be mutually exclusive. Nor would OTC pills seem to change anything about insurance coverage of other contraception forms, such as intrauterine devices (IUDs) or the Nuva Ring. 

The biggest misconceptions, however, seem to surround cost. Opponents point out that under Obamacare women can now get birth control pills with no co-pay, but without insurance coverage they may have to pay some $600 per year for birth control pills. But the pill's current prescription-only status has inflated its price, because pharmaceutical companies don't actually have to compete in the consumer marketplace. Doing so would almost inevitably lead to lower cost pills all around or pills sold at various price points, as we see with other non-prescription drugs. 

What's more, it makes no sense to compare the cost of prescription birth control to the cost of buying pills over the counter. When you're shopping OTC, you're only incurring the cost of the pills themselves. When we're dealing with prescription birth control, women must also factor in the cost of the at-least yearly doctor visits required to get a birth control permission slip, and the costs they're paying for their insurance coverage in the first place. Taking those things into account, the price differential between our "free" prescription birth control pills and our free-market OTC pills begins to shrink considerably. 

Lastly, affordability isn't the only factor in making something accessible. Those championing the contraception mandate as a way to increase access assume everyone always has insurance coverage. What about undocumented women? Or those between jobs and temporarily uninsured? What about young women who can't let their parents know they're on the pill? Or domestic abuse victims who want to keep this information from their husbands? These are just a few of the situations in which a woman would find OTC pills much more accessible and affordable than the prescription-only kind, even if those prescription pills came with no co-pay. 

It's one thing for progressives to question the sincerity of support that male GOP politicians have for OTC birth control (some of it's definitely a bit suspect), but trying to diminish the good OTC birth control could do in order to prop up Obamacare's contraception mandate is inexcusable. Those who claim they want to increase contraception access while panning OTC birth control entirely look a lot more like partisan hacks than people with women's best interests in mind. 

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  1. What about undocumented women?

    Undocumented how?

    1. Didn’t you hear?

      You now need a license to be a woman. It is in page 10,672 of the Obamacare law.

      1. Well, fuck. Guess I’m an undocumented woman now.

    2. Not documented in binders, duh.

  2. Elizabeth,

    The biggest assumption baked into the opposition is that something is free as long as an insurance company pays for it. It is undeniable that birth control pills would be cheaper if they were over the counter. The opposition to making them such pretends that they really are not more expensive as long as insurance companies are paying for them.

    Also, the opposition to this shows that for feminists this issue has nothing to do with women or women’s access to birth control. For feminists, this is about using the government to force religious people to violate their consciences and nothing else. If a proposal deprives feminists of the ability to do that, feminists won’t support it no matter how much it helps women. This issue is about totalitarian socialism not women’s access to birth control.

    1. It’s KULTURWARZ not-so-cleverly disguised as economics.

      1. At the end of the day, economics cannot be so neatly separated from culture.

        Controlling with whom individuals may do business is the same as deciding with whom they may associate.

    2. That and TEAM BLUE partisanship. We must oppose OTC birth control pills because that would undercut women’s support for ObamaCare, which induces them to vote Democrat.

      It’s all about electing the right people.
      Somehow, the R’s are going to woo you in with OTC birth control and then just when you least expect it, spring the abortion bans on you.

      1. Take all the pills you want-I just don’t want to pay for them. Birth control pills only ruin your morals & your health,not your entire reason for existence.

  3. I had to laugh this morning when I read these feminists’ groups responses to Republicans supporting OTC birth control. They’re just upset because it shoots down their “war on women” rhetoric.

    1. You know who actually isn’t on this new anti-OTC-birth-control bandwagon, though? Amanda Marcotte.

      1. I would expect smarmy statements similar to Warren’s support of the Import-Export bank.

        If the pill becomes cheap and easy to get then Amanda has less of an argument for making other people pay for women’s birth control.

      2. I am shocked, shocked do you hear…

  4. “I’m against it because he’s for it.”

    That’s what so much of politics has come down to these days.

  5. If it’s good policy that they’ve come around to, I don’t really care what got them there.

    And making birth control pills more widely available is good policy.

    ENB, If it was bad policy but still increased freedom would you still support it?

    1. How would that work?

      1. Legalize heroin could be considered bad policy but increased freedom.

        There are more then a few idiots right here who would think legalizing antibiotics is bad policy.

        Could spend hours just listing drugs.

        Hell how hard would it be to put an automatic kiosk at Walmart that gave you specs on the glasses you need all without an optometrist being involved.

        1. Making antibiotics available OTC would likely lead to resistant superinfections that would mean the end of huge swaths of, if not all of, the human race. We’re close to that now as it is, thanks to ridiculous overprescribing of antibacterial drugs for viral infections like colds and flu, and the many places on earth where people do have ready access to antibiotics and take them for spurious reasons.

          I’m assuming you mean idiots in a self-deprecating “all of us” way, as I think most of us at HnR understand this. To me it makes far more sense to allow opiates to be OTC than antibiotics.

    2. It’s not good policy but should be entirely left up to the individual.

  6. “Politicians suddenly discover their support for all sorts of policies when it proves politically advantageous to do so. ”

    Is there any indication the politicians named have ever opposed OTC?
    But even flip-floppers should be applauded if they can articulate their reasons for changing their mind (and don’t suddenly flip back again when it is politically convenient.)

  7. i need to go back and find the dozen or so examples of liberal-talking-point-retorts during the Hobby-Lobby Outragealypse to the “obvious question” as to “why are they bitching about Hobby Lobby ‘controlling women’s access to birth control’ when they should be pushing for The Pill being made OTC”…

    ..i swear, every time i made this point, it was like the Manchurian Candidate, where every single one of them repeated a canned-phrase that had apparently been distributed via the Borg Network or something, to the effect of,

    “HELLO?! Look= Serious health issues are serious, profits are evil, and medications need to be tailored to the individual and even though many other countries all allow OTC birth control it wouldn’t work because science and economics and anyway you just want to keep people from having their RIGHTS! WOMAN HATER!!”

    If that lacks any coherence, its because that’s how it worked. The retort was a combination of ‘experts say…’ and ‘corporations over people!’ and ‘its expensive’ and ‘health risks! children will eat them like candy!’

    I really do think John is right when he says its far more about “Forcing” the issue rather than any real argument about ‘access’. As with most environmental law, etc and other Progressive passions, its not the “issue” that matters – its that the issue can be used to gain MOAR CONTROL over the economy and force people to do shit.

    1. I also think there’s a strong element of tribal signaling and moral preening involved. Only by mindlessly parroting the the latest progressive talking point does one indicate his or her status as an evolved, compassionate, egalitarian, and all-around right-thinking human, even if the talking point is utter rubbish and/or completely contradicts yesterday’s talking point.

      1. It really is preening. That’s the one thing that all the millenial polls missed: mine is generation preen. They only care about being liked by everyone else. They’re deluded with the Facebook/Instagram culture and have turned into a roving band of low self-esteem narcissists who crave attention and being liked. Barack Obama was the perfect president for this generation coming of age.

      2. This is basically it. It’s liberal in-group signaling. You indicate your membership in the group by mouthing the correct talking-points.

        This is typically what happens when two progressives meet for the first time. One notices that the other one is using a reusable grocery bag, and compliments them on their environmental consciousness. The other one reciprocates by admiring the political bumper stickers on the other one’s car. The first then repeats a funny joke about Republicans that they heard on Jon Stewart. After these initial pleasantries, they engage in a discussion about the birth control mandate in which they are in violent agreement about how important it is and how much Republicans hate women. Having exchanged their mambership cards they can now recognize eachother as members of the club of Good Right-Thinking People Not Like Those Bad Conservatives.

        1. It’s amazing how many times I’ve seen the first-meeting conversation you’ve just described here in the Berkeley-Oakland area.

    2. I’ve generally discovered that the best way to engage in that debate is to start with this:

      “Look, no one wants to prevent you from breeding more than I do…”

  8. ZDude ths makes no sense at all man. Wow.

    http://www.Crypt-Anon.tk

  9. I just realized a potential downside to the policy of letting kids stay on their parent’s health plans until 26.

    The plan holder can view claims activity for everyone on the plan. That means So if a 24 year old woman goes to see a gynecologist, her mom and dad are going to know about it.

    I’m pretty sure these conversations have happened already. “Honey, I was just looking at the insurance claims on the website, and I noticed that you had an office visit at Women’s Choice Health Clinic, do you mind if I ask what that was for??? “

  10. I’m all for making birth control more easily available, but making it blanket-OTC isn’t a great solution, scientifically speaking. Since women’s hormonal balances can vary so much on an individual basis, there is no one-size-fits-all combined oral contraceptive–there are a lot of different ones, all with different amounts of progestins and estrogens. Perhaps this would be a good place for pharmacists to be able to make prescriptions.

    1. Under the current system, if a woman has a lousy reaction to birth control type X, she has to set up an appointment, take off work or school or whatever it is women do, go see the dr, and pay between a $20 copay and a $300 bill to get a new permission slip to try type Y. How does the lack of a one size fits all solution mean going to the dr between trials is a GOOD thing?

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