October 20, 2014 — Ensuring comprehensive insurance coverage for contraceptives and making birth control pills available over the counter "shouldn't be an either/or debate," Daniel Grossman, vice president of research at Ibis Reproductive Health and a clinical professor at the University of California-San Francisco, writes in a Los Angeles Times opinion piece.
Grossman notes that the issue has drawn increased attention amid conservative candidates' proposals to allow OTC sales of "birth control pills as an alternative to the contraceptive coverage guarantee built into" the Affordable Care Act (PL 111-148). Meanwhile, Democrats "emphasize the importance of maintaining the contraceptive coverage guarantee in Obamacare," he writes.
Grossman explains that even though birth control pills have "not yet been approved for over-the-counter sale, most of the medical establishment is in favor of that outcome" and agrees it is a safe option. In addition, reliable studies "show that women can use simple checklists to determine on their own whether the pill is right for them, and that when they can obtain the pill without a prescription, they stay on it longer than if they have to keep getting a prescription renewed." Further, public opinion polling has found that U.S. women support nonprescription access to birth control pills. However, women have concerns that birth control would be costly without insurance coverage, according to Grossman.
Grossman argues, "The best policy, the one that would help women effectively meet their family planning needs and reduce the high rate of unintended pregnancy in this country, is over-the-counter availability and insurance coverage for birth control pills," as well as "coverage for all other contraceptives approved by" FDA.
Grossman notes that while OTC birth control pills are likely "still several years down the road ... the apparent agreement among liberals and conservatives about the merits of moving the birth control pill over the counter is cause for excitement." Still, Grossman cautions that "constructive policy change" should only be made "as long as the gains made in one kind of access aren't undercut by losses in another" (Grossman, Los Angeles Times, 10/18).