By Enrica Nicoli Aldini
Oregon made birth control available for purchase directly at a pharmacy without obtaining a doctor’s prescription last January. California will do the same in March. And now, health care organizations in Illinois are working with state legislators to increase access to birth control methods without additional costs, possibly making it available over the counter.
“No specific steps have been taken so far to introduce over-the-counter birth control, but the conversation is starting to bubble up,” said Kathy Waligora, director of the Health Reform Initiative at EverThrive Illinois, an organization advocating for the health of women, children and families. “The issue is really being considered by a lot of people.”
The new legislation in Oregon and California does not technically make birth control available over the counter. While women can bypass a visit to their doctor, they will still have to fill out a questionnaire with a pharmacist before purchasing birth control.
Lifting the requirement for a prescription to purchase oral contraceptives altogether would certainly benefit women’s reproductive health, likely resulting in a decreased number of unintended pregnancies. However, offering over-the-counter birth control does present its hurdles, according to Brigid Leahy, director of government relations at Planned Parenthood Illinois Action.
Leahy explained that over-the-counter birth control might increase costs for women who do not have medical insurance. Currently, under the Affordable Care Act, women with appropriate medical coverage can purchase oral contraceptives without any additional copayment. However, most insurance plans do not cover the costs of over-the-counter drugs. This might inadvertently turn over-the-counter birth control into a barrier to women’s access to contraception, considering that according to Planned Parenthood estimates, a birth control pack can cost as much as $50 a month or $600 a year.
“It’s a double-edged sword,” Leahy said.
That’s why Planned Parenthood Illinois Action, EverThrive Illinois and other organizations such as the American Civil Liberties Union are working with lawmakers to pass legislation to increase coverage of oral contraceptives.
Under the proposed Illinois Contraceptive Coverage Act, insurance companies would be required to cover all forms of oral contraceptives approved by the U.S. Food and Drug Administration, including over-the-counter birth control and emergency contraception, Waligora said.
EverThrive Illinois recently partnered with the Section of Family Planning and Contraceptive Research at the University of Chicago to conduct a review of birth control coverage among health insurance plans in Illinois.
“Many insurance companies were not covering as wide a range of contraceptives as we would like to see,” said Lee Hasselbacher, policy coordinator at the Section. “The Affordable Care Act guidelines reflect the understanding that women should have access to the birth control that works best for them without additional costs — the legislation introduced in Illinois would try to make that a reality for women at a practical level.”
Waligora said it is still too early in the process to know whether women in Illinois can eventually purchase birth control through a pharmacist or directly over the counter. Plus, only the FDA can ultimately approve over-the-counter birth control “so the hurdles there are at the federal level,” Hasselbacher said.
For now, EverThrive Illinois and other organizations committed to women’s health are watching Oregon and California closely to see what happens, especially as health care providers in the two progressive states are assessing potential risks associated with the new regulations.
However, Waligora said that because birth control is a safe, low-risk medication, women can feel comfortable seeking guidance and explanations directly from pharmacists upon purchasing oral contraceptives, though that does not substitute regular medical checkups. She added that EverThrive Illinois has been directing its efforts at educating legislators and the general public about the benefits of over-the-counter birth control.
“Research shows that any time you can remove barriers to birth control, it’s more used and more effectively,” Waligora said. “Women have busy lives, and this is about decreasing any barrier, whether in costs or time.”