Donald Trump said birth control should be available over the counter, but some experts point out that could make it more expensive for women if it means birth control is no longer covered by insurance. (Photo: Getty Images)
Today Republican presidential nominee and former reality television personality Donald Trump told Mehmet Oz, MD, on his eponymous talk show that he believes birth control “should not be prescription” and that it should be available over the counter.
At first glance, this might make you want to jump up and do a happy dance — after all, it would seem that making birth control over the counter, and prescriptionless, would make it all the more easily accessible to even more women.
But women’s health care experts say a proposal such as Trump’s would actually do anything but.
The catch? Women would be responsible for the cost of their birth control fully out of pocket, not only eliminating the current $0 co-pay for contraception under the Affordable Care Act (ACA, known colloquially as Obamacare), but also crushing the possibility of birth control even being able to be covered by insurance. In other words, instead of paying $0 per year for contraception, women now could be looking at bills upward of $600 annually — no small cost for low-income women especially.
Furthermore, such a plan also ignores the fact that many forms of contraception — and, indeed, the most effective forms of contraception — cannot be made available for purchase on a drugstore shelf: So goodbye, long-acting reversible contraception (LARC), aka intrauterine devices (IUDs) and birth control implants, which are more than 20 times as effective as hormonal birth control pills, the patch, or vaginal rings, with an efficacy rate of 99.9 percent.
Since the introduction of the birth control coverage benefits in the Affordable Care Act, 55 million American women are now eligible for prescription birth control without any co-pays, resulting in a savings of $1.4 billion to birth control users since the ACA’s implementation in August 2012, according to the Huffington Post. According to the Planned Parenthood Action Fund, more than one in three women have struggled to afford birth control at some point in their lives, including 55 percent of women ages 18 to 34.
And contraception access and affordability play a major role in preventing unintended pregnancy, which already accounts for about half of all pregnancies in the U.S. and costs American taxpayers $21 billion a year, according to the Washington Post. That’s why it’s not a bad idea for birth control pills to be made over the counter, and thus more easily available to the women who need them, but it can’t be done blindly.
“We want the FDA to approve a birth control pill for over-the-counter sale — but that step alone will not help women unless elected officials make sure that insurance covers it,” a NARAL Pro-Choice America spokesperson explains to Yahoo Beauty. “Women are already paying for contraception in their health plans, and without insurance, it costs hundreds of dollars.”
The American College of Obstetricians and Gynecologists (ACOG) reaffirmed its opinion earlier this year, recommending that oral contraception be made over the counter with self-screening tools made available for women to check for potential contraindications. Although, as an ACOG spokesperson tells Yahoo Beauty, “ACOG supports over-the-counter access, but it’s more complicated than just that. Cost is a major factor.”
As the ACOG committee opinion states, it’s highly likely that “some women might be adversely affected by changing to over-the-counter [oral contraceptives] if they lose insurance coverage for their preferred contraceptive method” and that “any plan to improve access to [oral contraceptives] by moving toward behind-the-counter or over-the-counter access should address issues of cost.”
In a statement, Dawn Laguens, executive vice president of the Planned Parenthood Action Fund, said today, “Donald Trump’s birth control plan is simply unacceptable. Days after releasing a maternity leave “plan” for married women only, Trump wants to put access to birth control out of reach for millions of women by making it more expensive. Women shouldn’t have to choose between paying for birth control or buying groceries for the month.”