Sen. Patty Murray introduced a measure on Tuesday that calls for birth control pills to be sold without a prescription. The bill, which echoes recommendations from the American Medical Association, is likely to increase political wrangling over the Obama administration’s requirement that health insurers cover the costs of FDA-approved contraceptives.
Murray, D-Wash., and supporters such as Planned Parenthood and NARAL Pro-Choice America say the move is intended as a defense against congressional efforts to shut down the portion of the federal Affordable Care Act (ACA) that requires health insurance companies to cover one of 18 forms of birth control without co-payments.
Without insurance coverage, Murray says, the pill can cost up to $600 a year, making it out of reach for many women. The bill would make sure that insurance still covers the cost of birth control pills if the FDA approves that particular method for sale over the counter. Typically, insurance companies do not cover the cost of nonprescription drugs.
"Anyone will tell you, if something is too expensive, it doesn’t matter how easy it is to get,” Murray said in a call with reporters on Tuesday. “It might as well be on the moon. Affordability and access go hand in hand."
Dr. Nancy Stanwood, an obstetrics professor at the Yale School of Medicine, said that medical groups have long called for over-the-counter access to the pill because research shows that women are safely able to take the pill without the need for a doctor visit or a pelvic exam. “I think that this is very common-sense measure that Sen. Murray is proposing, and it’s very thoughtful in thinking ahead so that women continue to have access to birth control,” she said.
The ACA’s requirement for contraceptive coverage has drawn fire from some Republicans and religious groups. They argue that companies with moral qualms about covering their employees’ birth control, especially the morning-after pill and IUDs, shouldn’t have to do so. The battle culminated in the 2014 Hobby Lobby Supreme Court ruling, which found that closely held private companies could object to the provision on religious grounds.
Recent studies from the National Women’s Law Center and the Kaiser Family Foundation found that many women’s insurance plans either weren’t complying with the ACA’s mandate to cover the cost of contraceptives or were charging them for some of the costs. For example, the study found, insurers would reject coverage of hormonal patches or injections, on the grounds that women could instead be covered for birth control pills, which they classified as a comparable hormonal method.
In May, the Obama administration clarified the intention of the health care law, warning insurers that they have to cover all forms of birth control, without cost-sharing or other charges.
The legislation proposed on Tuesday calls for both over-the-counter access to birth control pills and for insurance companies to cover the cost, since even generic versions can cost a few hundred dollars for a year’s supply without health insurance. With insurance coverage, before the ACA provision on contraception coverage, the pill costs $15 to $80 a month, according to a 2012 report from the Center for American Progress.
California passed a law in 2013, expected to come into effect later this year, that will allow women to get birth control from their pharmacists.