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GOP still hates contraceptive coverage, is OK with letting poor women look at birth control in stores

A new Republican proposal could put oral contraceptives in stores. Too bad they cost so much without insurance!


Katie McDonough
August 19, 2014 6:18PM (UTC)

The GOP does not want your insurance to cover birth control, but a growing number of Republicans now support selling oral contraceptives over the counter so that women who can't afford the pill can at least get a real close look at it behind glass or something.

Selling oral contraceptives over the counter is a fine thing to do. It's an idea that lots of doctors and pharmacists really like. It has the potential to bring down prices across brands, and would eliminate the need to see a doctor every few months simply to renew a prescription for a medication you have, in all likelihood, been taking for years without incident.

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The trouble with the recent Republican push to expand over the counter birth control access is that it's being offered as an alternative to full contraceptive coverage under the Affordable Care Act, rather than as just another option offered to women. The conservatives who really, really like the idea of pharmacies selling the pill are the same people who really, really like gender rating in insurance and requiring women to pay extra for basic healthcare. They are also, in general, the same people trying to shut down reproductive health clinics and cut off public funding for family planning.

Bobby Jindal was ahead of the curve on this one, coming out for the proposal back in 2012 when the American Congress of Obstetricians and Gynecologists first officially recommended it. The new face for the policy is Colorado Republican Cory Gardner, who used to support personhood but doesn't all of a sudden and who doesn't support contraceptive coverage, but says that he supports access to birth control.

Beyond the whole thing of this being a cynical attempt to deflect criticism about the GOP's hostility toward reproductive freedom and women's bodily autonomy and poor people and social safety programs (and ...), the Republican "solution" of making oral contraceptives available over the counter is way, way too narrow a proposal to be any kind of solution at all.

Not everyone who needs or wants birth control can take the pill. (And because the Republican proposal is all about "personal responsibility" and ignores the matter of access to affordable healthcare, women who lack insurance but still want to talk to a doctor about the different contraceptives available won't have the option.) Some women can't use hormonal birth control for medical reasons, while others just prefer the copper IUD because it's long-term and considered by many doctors to be the "gold standard" in pregnancy prevention. IUDs are expensive, some can cost more than $1,000. And -- contrary to what New York Archbishop Timothy Dolan thinks -- you cannot buy them at your neighborhood 7-Eleven. (In fact, if the person working the counter at your neighborhood 7-Eleven offers to sell you a copper IUD, steer clear! That thing is probably fake as hell. The guy probably put some gold paint on one of those flossing picks or something.) Plus, IUDs need to be inserted by a physician. There's no getting around the doctor visit if you want an IUD, so insurance coverage is essential. The Republican proposal would leave women in these situations stranded.

And as a recent report from the Guttmacher Institute made clear, cost continues to be a barrier for millions of women who need birth control:

Many women cannot afford to pay for contraceptives and related services on their own, especially because some of the newer hormonal and long-acting methods that are most effective at preventing pregnancy are also some of the most expensive.

Among poor adult women in need, the percentages who were uninsured were even higher: 39–41 percent for women with family incomes below 137 percent of [federal poverty line].

So even with the increased coverage under the new healthcare law, millions of women living in or near poverty continue to lack insurance and basic access to affordable medical care. And the need for affordable birth control is growing faster than publicly-funded family planning clinics can meet it. Gardner and Jindal's so-called personal responsibility approach of putting full price oral contraceptives on pharmacists' shelves will do absolutely nothing for the women -- overwhelmingly low-income women and women of color -- who are hurting the most from lack of access and affordability.

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And rather than just leave a bad situation at its current bad level, the Republican assault on clinics like Planned Parenthood only makes things worse. And it probably won't surprise you that Gardner -- the great supporter of birth control -- voted to defund Planned Parenthood. So let's add that to the column of reasons that this GOP "fix" is just a transparent attempt to get women and other people who need affordable reproductive healthcare to hate them slightly less.

I predict it won't work in winning over voters, but am eager to see how the strategy plays out. It will be interesting to see if Jindal's belief that the "government shouldn't be in the business" of birth control gains more traction, and what, then, will happen to the conservative push to further immerse the government in the business of abortion care. A sensible person would say those are two contradictory impulses, but Jindal never claimed to be sensible.


Katie McDonough

Katie McDonough is Salon's politics writer, focusing on gender, sexuality and reproductive justice. Follow her on Twitter @kmcdonovgh or email her at kmcdonough@salon.com.

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