Making birth control available over-the-counter is a mainstream idea with broad support among health providers. The American Congress of Obstetricians and Gynecologists says that over-the-counter access to birth control pills “will help more women get the contraceptives they need, which have long been proven safe enough to use without a prescription — especially emergency contraception.”
Responding to a recent tweet by Ocasio-Cortez, Cruz proposed a “simple, clean bill” to do just that: increase access to birth control over the counter. Yet, due to a quirk in federal health law, Cruz’s proposal would do very little to actually expand access to birth control.
Though the Affordable Care Act requires insurers to cover contraceptive care, they only need to do so if the birth control is prescribed by a medical professional. Thus, a clean bill that simply makes birth control available over-the-counter, without expanding the rules governing insurers, will not meaningfully expand access to contraception. Patients would still need to go through the trouble of obtaining a prescription if they don’t want to pay for their birth control out-of-pocket.
At best, a clean bill would benefit relatively wealthy individuals who can afford to pay for the convenience of quickly buying birth control without first talking to a doctor.
Of course, there are ways to make birth control over-the-counter and ensure that it is covered by health insurance. As Slate’s Christina Cauterucci notes, 12 states and the District of Columbia permit pharmacists to “provide on-the-spot prescriptions for contraception, making it nearly as simple to pick up birth control at a drugstore as it is to acquire an over-the-counter medication, but with full insurance coverage intact.”
Several members of Congress also support legislation known as the Affordability Is Access Act, which would require insurers to cover oral contraceptives regardless of whether the patient has a prescription.
But making birth control available over-the-counter without doing anything else will do little to help anyone who doesn’t have a great deal of disposable income that they can afford to spend on convenience. Cruz’s proposal to work with Ocasio-Cortez appears to be nothing more than an effort to earn some lefty street cred for a sham proposal.
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