Over the past few weeks, politicians who have taken a hard-line stance against insurance coverage for contraception are offering a new alternative: make birth control available over the counter.

At first glance, this appears to be a welcome shift, a reflection of the growing support for making birth control available to more women.



It's not.

When health insurance doesn't cover birth control and women have to pay out of pocket at the drugstore, it won't expand access to birth control but shrink it. Thanks to the Affordable Care Act, more than 48 million women in the U.S. are eligible for preventive care, including birth control, with no co-pay. We're not just talking about the pill; we are talking about the full range of contraceptive methods approved by the Food and Drug Administration. That's 48 million women who are able to go to the pharmacy or a doctor's office and get birth control with no out-of-pocket costs. In the first full year of the birth control benefit, American women saved $483 million more (PDF).

So when politicians who have otherwise embraced policies that would drag women back to the 1950s suggest making birth control available over the counter instead of covering it in insurance plans, they're not experiencing a change of heart. They're suggesting something that would take us back to the days when women had to pay out-of-pocket for their prescriptions, making birth control harder to get for many women, not least women who use birth control methods that simply cannot be stocked on store shelves, like IUDs, one of the most effective (and expensive) forms of long-acting birth control.



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