There’s A New Fight About Birth Control (& It’s Not About Banning It)

Photo: Tom Williams/AP Images.
Politicians are battling over birth control — again — but the argument looks different this time. Two female U.S. senators have introduced bills related to over-the-counter contraceptives, and both women take for granted that birth control should be available without a prescription. At a time when state legislatures are passing restrictions on abortion and slashing support for poor families, this is an improvement over past legislative debates over women’s health. Last month, Sen. Kelly Ayotte of New Hampshire introduced a bill with fellow GOP Sen. Cory Gardner of Colorado that would make it easier for drug companies to get birth-control pills approved for over-the-counter sale by the FDA. In an op-ed for the New Hampshire Union Leader, Ayotte wrote, “I share the goal of increasing women’s access to safe and effective contraceptives.” It's common sense, but it’s also not something you’d necessarily expect to hear from a member of the same party as Todd “legitimate rape” Akin. That Ayotte and Republican presidential candidate Carly Fiorina are both talking about contraception as an essential component of women’s success appears, on the surface, to be a step forward. But, as reproductive health advocates and medical groups have pointed out, there’s a catch to Ayotte’s bill. The measure would make it possible for women to buy birth control over the counter, but it wouldn’t require insurance companies to offer it without a prescription, which could cost American women hundreds of millions of dollars each year. Ayotte has cited statistics from the American Conference of Obstetricians and Gynecologists to support her bill, but ACOG president Mark S. DeFrancesco, M.D., has spoken out against her proposal. "By making contraceptives available to women without a co-pay, it has truly increased access to contraception, thereby decreasing unintended pregnancies, and allowing women to better plan their futures,” he said in a statement. “Unfortunately, instead of improving access, this bill would actually make more women have to pay for their birth control, and for some women, the cost would be prohibitive." Right now, health insurance is legally required to cover birth-control prescriptions without a co-pay, thanks to the Affordable Care Act. Contraceptives bought over the counter wouldn’t be covered by that part of the ACA, which means they could get expensive fast. According to Planned Parenthood, birth-control pills can cost as much as $600 a year, which could put it out of reach for many low-income women. Washington Sen. Patty Murray’s bill would make FDA-approved birth control available without a prescription, and it would require your insurance to cover it. In an op-ed she wrote last week for Refinery29, Murray said, "Access and affordability go hand-in-hand. You can’t have one without the other." According to the National Campaign to Prevent Teen and Unplanned Pregnancy, more than 60% of young Republicans agree with Murray, a Democrat. Of young Republicans who use birth control, 65% think insurance companies should have to cover it. That’s not a small group of people — 99% of all women between the ages of 15 and 44 have used contraception at some point in their lives. The prognosis for both bills is still uncertain, but leaders would be smart to listen to opinions from these constituencies as they put together future policies. As members of the Senate debate what a future with over-the-counter birth control might look like, some of their colleagues are sticking to the older, more puritanical fights over reproductive rights. On Tuesday, House Republicans issued a proposal that would eliminate all Title X funding, which offers grants for groups to provide contraceptive and preventative health care to low-income women. The end of Title X could leave 4.6 million people without access to healthcare services, including affordable birth control. Women’s health care — and easy access to it for all women, rich or poor, urban or rural — is going to be an unavoidable topic for anyone running for office in 2016. The fact that we’re talking about more than just whether to cut off access to it is a welcome change.

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