California and Oregon have recently passed measures that will begin in the next few months, allowing pharmacists the legal right to provide prescriptions for contraceptives to women over the counter.
Pharmacists will be authorized to prescribe contraceptives after a quick screening process in which women fill out a questionnaire about their health and medical histories. The contraceptives will be covered by insurance, as they are now.
The laws are the latest effort to make birth control more accessible, a longstanding goal of medical professionals and policy makers. But unlike other recent debates over contraception — including the firestorm over the Obama administration’s requirement under the Affordable Care Act that all health plans pay for contraceptives — these legislative efforts have been largely free of political rancor.
The hope here is that making contraception easier to acquire for women will make for healthier women, less unwanted pregnancy, less abortions, less unwanted children. However, there are numerous issues brought up by these new laws. Some believe that this law obfuscates the real need to make all female contraception over-the-counter without any prescription.
There are bills being introduced trying to ensure that over-the-counter contraception will remain covered by insurance.
A bill introduced in Congress in May by Republican senators would help expedite the process in which contraceptive manufacturers apply to the Food and Drug Administration for over-the-counter approval, but some Democrats and women’s groups say it might ultimately reduce birth control use because it does not specify insurance coverage for over-the-counter methods. In response, Democrats have introduced a bill stipulating that contraceptives would remain covered if they were to become available without a prescription.
While having easier access at pharmacies to contraception should help underserved communities, the costs in terms of insurance coverage are still unknown—and might get murkier before they get clearer, thanks to our Congress’s wonky relationship with healthcare insurance and women.
One unanswered question, however, is whether insurers will pay for the time pharmacists spend reviewing women’s questionnaires or helping evaluate options. To cover that cost, some pharmacists may charge fees of $25 or more, which could be an obstacle for some women.
The laws in Oregon and California differ in some ways. California’s has no age restriction; the Oregon law requires that teenagers under 18 obtain their first contraceptive prescription from a doctor. In California, pharmacists will also most likely have to take women’s blood pressure for contraceptives containing estrogen.
