The Food and Drug Administration moved one step closer to making birth control pills available over the counter when a panel of experts voted unanimously to recommend the move last week. In an era of increasingly difficult access to reproductive health care, the availability of over-the-counter birth control will make it easier for people to plan and prevent pregnancies across the country.
But Democratic lawmakers want to make it more accessible, ensuring that health insurers provide free coverage of oral contraceptives by passing the Affordability Is Access Act.
Sen. Patty Murray (D-Wash.) and Rep. Ayanna Pressley (D-Mass.) is expected to reintroduce the legislation Thursday, after first promoting it last year.
The FDA is scheduled to announce its decision on whether to reclassify the drug this summer.
“We want to make it very clear that, if the FDA approves it — which I hope they do — that women will not only have access to it, but that they can afford it,” Murray told HuffPost on Wednesday. “We need to do everything we can to make sure women can make their own health care choices.”
Pressley points to some of the factors that can keep people from getting contraception: transportation, affordable childcare, a regular doctor who takes their insurance, and having health insurance to begin with.
Expanding access as much as possible is “changing lives for millions,” he said.
Co-leaders of the proposal are Reps. Alexandria Ocasio-Cortez (DN.Y.) and Ami Bera (D-Calif.), as well as Sens. Mazie Hirono (D-Hawaii) and Catherine Cortez Masto (D-Nev.) .
HRA Pharma, a division of Paris-based drugmaker Perrigo, has begun the process of asking the FDA to approve over-the-counter sales of the birth control Opill in the summer of 2022.
The Opill is a progestin-only birth control that was first approved by the FDA in 1973. (Other types of birth control pills contain an additional hormone, estrogen.) A progestin-only pill can be a good option. for people who experience side effects of some types. of oral contraceptives. It is highly effective – more so than condoms – but less effective than implanted birth control devices, according to the FDA.
The company has not yet said how much the drug would cost when obtained over the counter without insurance coverage.
Major medical groups including the American College of Obstetricians and Gynecologists and the American Medical Association support making oral contraceptives available over the counter.
But some FDA experts have expressed concerns over reclassifying them.
Over two days last week, an FDA panel held hearings to discuss the move, including data provided by the manufacturer that was deemed flawed. (Some study participants returned “impossible” tracking diaries, saying they took more pills than they were prescribed.)
Some have also questioned whether young adults and women can rely on proper self-administration of the drug, taking care to take it at the same time every day and avoiding it if they have certain pre-existing health conditions. .
“I’m kind of stunned that they say things like this, frankly,” Murray told HuffPost.
“Can’t we trust women who take the pill at the same time? Oh, my God, talk to any girl. You know how we manage our lives in many ways – we certainly know how to take medicine,” he said.
“We definitely have to trust our own bodies,” Pressley added.
Proponents argue that five decades worth of use also clearly points to Opill’s safety.
A panel member, Dr. Katalin Roth, a professor of medicine at George Washington University, told The Washington Post that any reservations she has are outweighed by concern over the barriers some women face in obtaining contraception.
“We knew there was a need,” Roth told the Post.
The poll indicates that Democratic and Republican voters are likely to support making oral contraceptives available over the counter by a wide margin: 71% said they are for it in a survey conducted last year by the Contraceptive Access Initiative, a nonprofit advocacy group.
But with the House in Republican hands, led by Speaker Kevin McCarthy (R-Calif.), Democrats’ proposal to expand access by removing cost barriers faces a difficult path to becoming law.
“It’s an uphill battle, of course, but you don’t win a battle by going, ‘Oh, that’s too hard,'” said Murray, who led the effort to make Plan B emergency contraceptives available. at the counter with then-Sen. . Hillary Clinton (DN.Y.) in the 2000s.
He sees clear parallels between that fight and the current push for over-the-counter birth control.
“It’s the same game,” he said, noting how the FDA feared the conservative backlash to its Plan B decision nearly two decades ago.
Right now, conservatives appear to be using every last tool at their disposal to attack reproductive health care.
“They don’t stop. They are complete,” Pressley said. “And so we need to be both, using every lever at our own disposal to protect and expand access to affordable over-the-counter contraception.”
When it became law in 2010, the Affordable Care Act said insurance companies had to provide free access to birth control, although it carved out exemptions for certain religious groups. That rule still stands, but Mara Gandal-Powers, senior counsel for the nonprofit National Women’s Law Center, told HuffPost there are other complicating factors.
Currently, insurers may still require a prescription to provide coverage for birth control pills, even if they are not medically necessary; the Affordability is Access Act will change that.
The Supreme Court also threw a wrench in birth control access with its 2014 decision in Burwell v. Hobby Lobby Stores, which said that “closely held” for-profit corporations can also claim religious exemptions. Donald Trump’s presidential administration then “drove a Mack truck” through the situation by allowing “almost any entity” to claim a religious or moral exemption, Gandal-Powers said.
President Joe Biden’s administration is now in the process of rolling back some of Trump’s changes while reminding insurers of their legal obligations.
