September 22, 2014 — Conservatives' proposal for "[o]ver-the-counter sales of birth control pills would be no panacea for religious dilemmas posed by Obamacare" and could increase women's out-of-pocket costs, but "[f]rom a purely medical perspective ... the case for over-the-counter sales is strong," a Washington Post editorial argues.
The Post explains that the Republican senatorial candidates touting this proposal claim it would "honor [the] beliefs" of employers with religious objections to the Affordable Care Act's (PL 111-148) contraceptive coverage requirements while ensuring that "their female employees could still get their contraceptives."
"Well, not exactly," the Post argues. One problem is that oral contraceptives are "hardly the only method" of contraception, the editorial notes.
"Implants and intrauterine devices [would] remain eligible for full coverage," meaning that the conservatives' OTC proposal would do nothing to end religious objections to those methods, the Post explains.
Further, because the contraceptive coverage benefit ensures that women with private insurance have access to birth control prescriptions without copayments or other out-of-pocket costs, "many [women] would paradoxically face higher upfront costs than they do now" if they purchased birth control pills OTC without a prescription, the Post contends.
However, the Post also notes that there is a medical case for ending prescription requirements for oral contraceptives, if the change is done correctly. The American College of Obstetricians and Gynecologists endorsed OTC sales in 2012, and the American Academy of Family Physicians also supports the idea.
OTC access to oral contraceptives could "help improve women's access to needed health care, thus preventing the individual and social costs of unintended pregnancy," but "if and only if accompanied by measures to ensure affordability," the editorial argues.
The editorial also argues that because FDA is "more likely to reclassify a prescription drug like the pill at the request of the manufacturer, rather than at the agency's initiative," a move to OTC sales likely would not occur unless the manufacturers call for it.
In addition, to ensure affordability, there would need to be adjustments to both the ACA "and the food and drug laws, which, in turn, would require a sustained bipartisan effort in both houses," which seems unlikely given the partisan rhetoric surrounding the issue, the Post concludes (Washington Post, 9/21).