OTC birth control arrives amid the battle over reproductive rights

Cheap, easy birth control is arriving in the United States. The country's first over-the-counter birth control pill "will soon become the most effective birth-control method available without a doctor's visit," said The Wall Street Journal. The pill — called Opill, available for $19.99 a month — is a "milestone that reproductive activists have pursued for decades." And it comes amid fierce political battles over reproductive rights in America.

One might ask why it took so long for OTC birth control to get here. America, after all, follows "more than 100 countries that permit the sale of contraceptive pills without a prescription," said Axios. Whatever the reason for the delay, it's clear that the end of Roe v. Wade in 2022 provided some urgency to the effort: The American College of Obstetricians and Gynecologists argued in recent years that easing access to the pill was "critical so that more people can control their reproductive fates."

The availability of birth control in the United States has traditionally "been dependent on access to health insurance and to a regular health care provider who could prescribe it," said the Center for American Progress, a liberal think tank. For many women, "use of and access to family planning services varies considerably." Opill's new availability removes some of those barriers, which "marks a pivotal moment in birth control access."

Is insurance coverage next?

While the price tag for Opill is relatively low, some lawmakers want to make it even cheaper for buyers. "Dozens" of congressional Democrats in October called on federal agencies "to ensure that private health insurance plans will fully cover the pill without a prescription," said CNN. And Sen. Patty Murray (D-Wash.) last year introduced the "Affordability is Access Act," which would put that requirement into law. Murray — along with Sens. Mazie Hirono (D-Hawaii), and Catherine Cortez Masto (D-N.V.) — this week renewed the call to pass the bill. "More needs to be done to make sure every American can access and afford the pill over the counter," the senators said in a joint statement.

That might be smart election-year politics for Democrats. Opposition to protections for birth control "may come back to haunt Republicans in November," The New York Times said. Recent polling shows that 80% of voters say that access to contraceptives is "deeply important," and that 72% had a "favorable view" of birth control. All but eight GOP members of the House opposed a 2022 bill to protect contraception. But nearly two-thirds of poll respondents said that made them less likely to vote Republican this year — a "political crisis" for the GOP.

The recent Alabama Supreme Court ruling — affirming personhood for frozen embryos used in vitro fertilization — has only intensified the crisis. Now Democrats are "seeking to make the connection between Alabama's IVF decision and birth control restrictions," said The Guardian. Republicans are trying to find a middle ground on the issue, expressing support for IVF without alienating their anti-abortion supporters. It's a tricky balancing act. "They can't win without anti-abortion base voters," said one observer.

'Little public opposition'

Given those fights, it's notable that federal approval for Opill "faced very little public opposition from conservative groups," said The New York Times. While some Catholic organizations pushed back against the pill, other groups that are "often critical of measures that increase access to abortion, emergency contraception and sex education" stayed silent on the topic. That could prove a rare break from political battles this year. "The issue of reproductive rights was always going to loom large in the 2024 U.S. elections," said Voice of America.

In the meantime, CNN said, consumers should start to see the pills on store shelves in the coming weeks. Under the Affordable Care Act, most health insurance plans will cover the cost — and Perrigo, the company behind Opill, said it will soon announce a "cost assistance" program for low-income people. The idea, said one company official, is to "ensure both affordability and availability on shelf."