WASHINGTON — These days, prominent Republican Senate candidates and at least one potential 2016 presidential candidate are championing the idea of over-the-counter birth control, setting up the potential for actual bipartisan action on the issue.
One problem: Doctors and pro-choice activists say they don't actually believe the Republicans are serious.
For years, progressive-leaning (read: pro-choice) women's rights groups, medical professionals, and drug manufactures have been calling for the contraceptives pill to be sold over the counter at pharmacies, without prescription. Now they have Republican support for the idea. People like Gov. Bobby Jindal, a social conservative and potential Republican presidential candidate, are arguing the policy is sound.
"I would generally follow the lead of associations the like the College of OBGYNs [sic]. We all too often have politicians become experts in things they know nothing about," Thom Tillis, the Republican nominee for Senate in North Carolina and a proponent of over-the-counter contraceptives told BuzzFeedNews in an interview last week. "I think when you have an organization like the American Colleges of OBGYNs making these kind of recommendations we should look at them."
But that support is sputtering out badly among medical groups and other longtime proponents of selling contraceptives like Tylenol. This week, the American Congress of Obstetricians and Gynecologists has gotten as far away from Tillis and his fellow Republicans over-the-counter contraceptives advocates as it possibly can.
"It makes me a little suspicious," Dan Grossman, a doctor and ACOG's chosen spokesperson when it comes over the counter contraceptives access, told BuzzFeedNews Monday evening. "They really don't understand this issue in much depth."
Grossman wasn't done. "It seems a little disingenuous," he added.
On Tuesday, ACOG president John Jennings took a softer tone in his own statement but the message was clear: The OBGYNs are not impressed.
"Recent political discussions on the importance of (over-the-counter) access to contraceptives are welcome," Jennings said, "but ACOG remains firmly in support of comprehensive strategies to increase adoption of more-effective methods and to provide all women with the contraceptives they need at no cost."
Meanwhile, the pro-choice groups have issued a collective eye-roll at the Republican proposals. After Colorado Republican Senate nominee Cory Gardner offered up his support for over-the-counter contraceptives, Planned Parenthood told the Huffington Post it was a "cynical ploy" designed to "whitewash" his past support for bills pro-choice women's groups oppose like the so-called "personhood amendment".
A deep political split over women's health care access pits Republicans against pro-choice groups and medical professionals — there's nothing new about that. But taken solely on its own, Republicans really are doing something new with contraceptives this election year and opening the door to some kind of bipartisan compromise on an issue near and dear to women's rights groups.
For example, by calling for contraceptives without a prescription, Republicans are walking away from social conservatives. Religious Republicans mostly oppose the sale of contraceptives methods like Plan B taken after sex, but they generally don't oppose the sale of conventional contraceptives (a pill, taken daily). They're not thrilled at the prospect of people being able to buy it without a prescription, though.
"We would prefer that young women who get talked into doing things by, you know, boyfriends talk to a doctor," said Connie Mackey, president of the Family Research Council's PAC. "But we don't take a position on straight birth control, only on abortifacients."
Some social conservatives say drugs like Plan B are tantamount to abortion and are abortifacients, a stance not backed up by medical professionals.
Republican women's groups aren't jumping on the idea of over-the-counter contraceptives either, but they prefer it to Plan B.
"Any policy on birth-control medication should also take into consideration the important screenings that doctors perform in an office visit for a birth control prescription," said Penny Nance, president of the conservative Concerned Women for America. "The bigger health issue however, is the fact that Plan B, which is 40 times stronger than birth control, is currently offered over the counter with no age restrictions."
The thorny political issues surrounding contraceptives — abortion, Obamacare and women, social conservatism, women's rights — are exactly the issues Republicans are trying to avoid by embracing over-the-counter contraceptives sales. But they're also the issues keeping pro-choice women's groups from giving the Republican proposals the time of day — even when they agree.
Over-the-counter contraceptives are also something just about everyone in the pro-choice movement wants. Planned Parenthood, NARAL Pro-Choice America, Association of Reproductive Health Professionals, ACOG, ACLU, and many, many more are all part of the Oral Contraceptives Over-the-Counter Working Group, an alliance focused on expanding access to contraceptives by eliminating the step of a doctor's consultation. To the members of the group, an end to prescriptions for some contraceptives is a key in expanding access.
"There is evidence that the current prescription status for hormonal contraception may serve as a barrier to access for many women," reads the group's "statement of purpose." Minority women would be especially likely to take advantage of over-the-counter contraceptives, the group says.
Not only does the working group want over-the-counter contraceptives, it wants changes to Obamacare to get it. Current Obamacare guidance states insurance companies must cover all FDA-approved forms of contraceptives without a co-pay, but if insurers wish, they may require a prescription to get contraceptives. They note that several states allow women to walk into drug stores with Medicaid cards and walk out with the only over-the-counter oral contraceptive available, Plan B, without any money exchanging hands.
"Our ideal: the pill would go over-the-counter and be covered by insurance over the counter," Grossman said.
The insurance industry isn't weighing in on whether contraceptives should be available over the counter, but a senior industry official said the FDA allowing the sale of contraceptives over the counter wouldn't make much difference for coverage.
"Our sense is this wouldn't have much impact on insurance at all. Even if it's over-the-counter, health plans would still be required to cover it at no cost," the official said. "As long as they don't repeal the part of the law that says insurance must cover it, it would still be free to those with insurance."
And here's where the Republicans start losing their chance to make new friends in the contraceptives access advocacy community with their over the counter contraceptives message.
The ideal world of over-the-counter contraceptives pills for current Republican advocates is a world where the Affordable Care Act doesn't exist, meaning it's a world where insurance companies are no longer required to offer contraceptives with no co-pay whatsoever. Jindal, the Louisiana governor who is the most prominent Republican proponent of contraceptives over the counter, would like to lift requirements like that, a scenario that likely involves insurance companies charging what they want for contraceptives coverage.
"Insurers would probably continue to cover it because the market would demand it," said a senior Jindal aide. But the goal of the policy change is to "get the federal government out of health care choices," the aide said. In addition, Jindal wants to see drugs like Plan B banned. Jindal also wants an 18-year-old age limit on contraceptives sales, which most of the pro-choice groups oppose.
"We are very clear to use the word contraception," said the aide. "The difference is between contraception and birth control after conception."
Evan McMorris-Santoro is the White House correspondent for BuzzFeed News.
Contact Evan McMorris-Santoro at firstname.lastname@example.org.
Kate Nocera is the managing editor for BuzzFeed’s Washington, DC bureau. Nocera is a recipient of the National Press Foundation's 2014 Dirksen Award for distinguished reporting on Congress.
Contact Kate Nocera at email@example.com.
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