Here's my Courier-Journal column on why Republicans should support making birth control pills available.
Thanks to the C-J for giving me permission to reprint it here:
A group of Senate Republicans has introduced legislation on something all Republicans should support: a step toward making birth control pills available over the counter (OTC). This is good policy and good politics. It puts to rest the fake War on Women narrative that Republicans have a secret plan to bring back chastity belts.
Colorado Republican Sen. Corey Gardner beat Democrat Sen. Mark "Uterus" Udall last year partly due to Gardner's pledge to work to make birth control pills available OTC. Props to Gardner for keeping his word, and to Republican Senators Kelly Ayotte, Joni Ernst, Richard Burr, Ron Johnson and Thom Tillis for co-sponsoring.
Birth control pills have been around for 50 years. They are safe and effective. To be sure, oral contraceptives carry certain risks, such as the occurrence of a blood clot. But those risks are very rare — less common than blood clots during or after pregnancy.
Even aspirin poses risks, yet it is available OTC. So is "Plan B," the emergency contraceptive that is taken after sex. Chemically, it is a very strong version of the same hormones commonly found in birth control pills. It makes no sense for Plan B, but not birth control pills, to be sold over the counter.
Many doctors agree. The American College of Obstetrics and Gynecologists (ACOG) opined in 2012 that: "Weighing the risks versus the benefits based on currently available data [oral contraceptives] should be available over the counter."
Although the ACOG recommends that women continue to get routine screenings for cervical cancer and sexually transmitted diseases, it made clear that a pelvic exam is not necessary and should not be required to get oral contraceptives. Further, it found that women can competently and safely evaluate their own risk factors by using a checklist. (Imagine: treating women like grown ups.) Some women will prefer to discuss family planning with a doctor, and that's fine. Let it be their choice, not a requirement,
In addition to its safety, the pill works, but only if it's used. But women can't take what they can't get with reasonable convenience.
The ACOG noted that unintended pregnancy "remains a major public health issue" in this country; OTC birth control pills would "improve access and use, and possibly decrease unintended pregnancy rates."
The Center for Disease Control estimates that 50 percent of all pregnancies are unplanned. Studies suggest that OTC birth control pills could cut that number in half, which has huge public health implications: For a young girl trying to finish high school, the ability to buy the pill OTC could allow her to escape poverty.
Every abortion stems from an unwanted pregnancy. Pro-life Republicans therefore should support making birth control pills accessible. Those who have moral objections to contraception should consider that the prescriptive status of the pill has no bearing on the morality of using it.
Access to birth control pills is particularly important for states like Kentucky with large rural areas and a shortage of medical providers. Finding and getting in to see the doctor is difficult and time-consuming — even if the doctor's visit is "free" under Obamacare. Forcing women to see their doctor for a birth control pill prescription wastes the time of patient and doctor and makes it harder for everyone else to get seen.
It's important to note that the issue of paying for birth control pills is wholly separate from the issue of whether it is medically necessary to require a prescription. Insurance companies could still cover the cost.
Regardless of who pays, making the pill available OTC will drive the price down. There are approximately 100 versions of the pill. Making contraceptives available over the counter should cause prices to drop and products to improve. The allergy medicine Zyrtec, for example, cost $90 a month by prescription 20 years ago. Now a year's supply of the generic OTC costs $30. Deregulation and competition save consumers money.
The U.S is way behind the rest of the world on this issue. Most countries allow women to buy oral contraceptives without prescription. That makes the U.S. less free in this regard than, for example, Kuwait. How bizarre that it's easier to buy the pill in Kuwait than in America.
Under current federal law, the pill cannot become available OTC until the pharmaceutical manufacturers so request. Gardner's legislation encourages them to apply by waiving the filing fee and providing priority FDA review. Big Pharma needs to be encouraged, strongly, to apply now. After a half century of use, there is no need for expensive, time-consuming studies. If pharmaceutical companies don't apply, Congress should revise the relevant statutes to allow consumers to make the request.
Republicans don't want to outlaw birth control. To the contrary, let's make it cheaper and easier for women to obtain.