Colorado Republican Cory Gardner is
doing his damnedest to shake his anti-choice past and support for a personhood amendment that would elevate a fertilized egg to being a legal person. That amendment would have the end effect of banning many forms of birth control. His opposition to basic women's health care extends beyond that, though. He's opposed to the provision of Obamacare that allows women to get birth control without insurance copays. Recognizing just how radical, just how misogynistic that might sound to Colorado voters, Gardner is now trying to position himself as a champion of birth control by saying he thinks birth control pills should be sold over the counter.
Gardner's not alone in this. In North Carolina, Republican Senate candidate Thom Tillis has taken the same position. Sens. Kelly Ayotte (R-NH) and Mitch McConnell (R-KY) introduced legislation pushing the FDA to study the issue. Here's what's wrong with their position, summed up by the leading authority on reproductive health and rights, the Guttmacher Institute.
Making birth control pills available over the counter, if done right, would meaningfully improve access for some groups of women. However, such a change is no substitute for public and private insurance coverage of contraceptives—let alone justification for rolling back coverage of all contraceptive methods and related services for the millions of women who currently have it.
The problem is that these Republicans are pushing for over-the-counter pills as a substitute for the contraception mandate in the law. They're still pushing for full repeal of the law, and at the least an end to the mandate. They argue that OTC pills would end the need for it, and would solve any problem for women. Clearly, they aren't too familiar with women.
That's because the pill isn't the only birth control out there. Guttmacher points out that the average woman will use four different methods of contraception in her reproductive lifetime. Not only do many women choose other methods, plenty of women can't use the pill. The most effective methods besides the pill are the most expensive ones—like the IUD or implant. These devices are expensive and on top of that, require a trained healthcare provider to insert. That can run $500 to $900. Not having that covered by insurance is a big problem for a lot of women. And even for the pill as far as costs go, under Obamacare the out-of-pocket cost for a woman is $0. That won't be matched on a drugstore shelf.
Putting the pill on the drugstore shelf is a good idea. It would greatly increase access to the pill to the uninsured and would be a great convenience. Plenty of developed nations have made it available without a prescription for years, without serious health consequences. But it is no substitute at all for what we have now—full coverage of prescription birth control in the law.