To make birth control pills easier to afford and more accessible, Sens. Kelly Ayotte (R-NH) and Cory Gardner (R-CO) are sponsoring Senate Bill 1438, the Allowing Greater Access to Safe and Effective Contraception Act.
The bill would allow the sale of hormonal contraceptives over the counter (OTC) without a prescription.
Since the Affordable Care Act was implemented, private health insurance plans have been required to cover prescription contraceptives, and average out-of-pocket spending on birth control pills and intrauterine devices (IUD) has dropped significantly.
Devon Herrick, a senior fellow at the National Center for Policy Analysis, says one significant problem is mandated benefits are not free. They come with costs that would be more efficiently borne by individuals.
Dr. Roger Stark, a health care policy analyst at the Washington Policy Center and a retired physician, says research shows each health benefit mandate adds 0.5–2.5 percent to the overall cost of health insurance. Consequently, the “free” insurance-provided birth control is actually expensed out in the cost of health insurance and results in higher premiums for everyone, including those who do not use them.
OTC Lowers Costs
Herrick says allowing hormonal contraceptives to be sold over the counter without a doctor’s prescription would benefit millions of men and women, because prices for prescription drugs often fall by 90 percent or more within a few months of losing patent protection and becoming available over the counter. Oral contraceptives would likely follow the same trajectory.
“Over-the-counter drugs definitely decrease the cost of drugs, especially when you consider the cost of the appointment to see the provider to obtain the prescription,” Stark said.
Special Interest Opposition
Herrick says many special-interest groups oppose the bill.
“Planned Parenthood and the American College of Obstetricians and Gynecologists are opposing the bill merely because they don’t want women to have to pay for birth control,” said Herrick. “They would rather force insurers to pay $30 to $40 per month on contraceptive mandates than have women pay $10 for the same product sold more cheaply OTC.”
Given the greater convenience and lower cost, making birth control pills available over the counter should be a no-brainer, says Greg Scandlen, an independent health care analyst.
“They would be far less expensive, much more convenient, and would save women the cost and time of a physician’s office visit to get prescriptions renewed,” Scandlen said. “But, as with all things in health care these days, whether to do this becomes a political calculation, rather than a medical or economic decision. Interest groups oppose the idea solely because keeping women dependent on the largesse of Obamacare means more Democrat voters. There is no other reason.”
No Need for Visiting Doctors
Prior to the passage of Obamacare, allowing the sale of birth control over the counter would have been hailed by liberals as a great achievement for women, says Merrill Matthews, a resident scholar with the Institute for Policy Innovation.
It would have improved access to care by lowering out-of-pocket costs and eliminating the need to spend time and money to see a doctor for the prescription, which is a bigger burden for hourly workers and lower-income women, Matthews says.
“Obamacare may pay for the doctor’s visit and the birth control, but it doesn’t reimburse women for the hours missed at work to see the doctor,” Matthews said.
Kenneth Artz ([email protected]) is managing editor of Health Care News.
Devon Herrick, “Over-the-Counter Contraceptives Better than a Mandate,” National Center for Policy Analysis, July 1, 2015: http://healthblog.ncpa.org/over-the-counter-contraceptives-better-than-a-mandate/