For many people, obtaining birth control can be a costly endeavor, and nothing short of a timesuck. But if Representative Alexandria Ocasio-Cortez (D-NY) can make good on the new bill she’s co-sponsoring, we may be one step closer to birth control being offered as an over-the-counter medication — without a prescription.
On Thursday, June 13, Ocasio-Cortez followed through. Representatives Ami Bera (D-CA), Katie Hill (D-CA), Ayanna Pressley (D-MA), and Ocasio-Cortez introduced a House bill called the “Affordability Is Access” Act, which would make over-the-counter birth control even more affordable and accessible for those who wish to take it; Senator Patty Murray (D-WA) introduced a partner bill in the Senate.
“If and when the Food and Drug Administration approves an oral birth control that is available over-the-counter, such birth control should be covered by health insurance, without a prescription and without cost-sharing,” the bill posits.
The bill’s sponsors also advocate for making birth control affordable even if you don’t have insurance, as is currently the case for around 13.7% of Americans.
“It is a brutal form of oppression to seize control of the one essential thing a person should command: their own body,” Rep. Ocasio-Cortez said in a statement provided to Refinery29. "Women should have the right to own and control their own bodies. I am proud to support the #FreethePill legislation, which would make birth control over-the-counter.”
Currently, the only oral birth control pill you can buy over-the-counter is Plan B, the emergency contraceptive, but manufacturers advise against using it as a regular birth control method, given that other methods are more effective. So if you want to begin taking a daily pill, you need a prescription, an extra step that many doctors have said isn’t necessary. That means people looking for reproductive autonomy need to schedule a doctor’s appointment, take time off of work to make the appointment, pay for that visit, work with their doctor to pick one out of at least 100 different kinds of oral birth control pills available, go to the pharmacy, and pay for their prescription. The cost can vary based on whether you have insurance, and what type of insurance you have; and the time-consuming nature of all those tasks can also serve as a deterrent to people who need such medication.
There are some workarounds, including policies in 12 states and Washington, D.C., that allows pharmacists to prescribe the pill in-store, Slate points out. But the road to true OTC status is a ways away, especially given that offering the pill up to the free market would mean that some employers could do away with including contraception in their health-insurance plans, which is currently mandated under the Affordable Care Act. (The ACA does not cover other OTC birth-control methods, like condoms or Plan B.) That may be why some Republicans, including Senator Ted Cruz (R-TX), also support freeing up the pill to an OTC world — simply put, part of their whole thing is not wanting to pay for it themselves.
But the Affordability Is Access Act isn’t everything Cruz might have wanted it to be. It wouldn’t leave people whose birth control is suddenly available over-the-counter in the cold; the bill would mandate that health insurance providers would still be required to cover the pill and not resort to cost-sharing methods such as deductibles. In short, the Affordability Is Access Act wants to make birth control more accessible to people regardless of their insurance status.
The FDA currently requires a prescription for oral contraception given its (rather exhaustive) list of potential side-effects, doctors still generally believe the benefits of such access outweigh the risks. As Dr. James T. Breeden, an OB-GYN, told NPR in 2012, “It is much worse to have a woman who is hypertensive be pregnant than to be on birth control pills.” It’s not clear where the FDA stands on approving an over-the-counter birth control pill.
According to the Affordability Is Access Act’s sponsors, this bill is urgent. Rep. Hill said in a statement, “Reproductive healthcare is as personal as it is critical. We’ve seen over and over this administration’s attempts to roll back the basic rights of women and make it harder for them to access birth control. It’s time to stand up and loudly say: Not on our watch.”
“Reproductive justice is not only a healthcare issue, it is also an economic issue and a civil rights issue,” Rep. Pressley added. “At a time when reproductive rights are under attack, it is more critical than ever that we take bold steps to reaffirm reproductive rights for all Americans.”