First, birth control medications will NOT become OTC in Oregon and all insurance coverage still applies. Drum didn’t bother to check the legislation for what it actually says. HB 2879 allows PHARMACISTS to prescribe birth control medications to women over 18 after they fill out a health questionnaire and are counseled by the pharmacist. There are other safeguards built into the language of the bill as well. AND Section 2 of the legislation contains this language: “(3) All state and federal laws governing insurance coverage of contraceptive drugs, devices, products and services shall apply to hormonal contraceptive patches and self administered oral hormonal contraceptives prescribed by a pharmacist under this section.”
Okay, this is just a massive expansion of the allowed prescriber universe without touching the prescribed vs. non-prescribed categorization of hormonal birth control. This is a net win for women with current insurance, and women who want birth control but can’t easily get to a prescribing doctor. Very different story.
My bad for not reading the source documentation.
Kevin Drum is commenting on a recent decision by Oregon to allow hormonal birth control to be sold over the counter:
I know there’s some disagreement about this among progressives these days, since prescription birth control is covered by Obamacare and OTC birth control isn’t. But I assume Oregonians who want a prescription can still get one, and allowing contraceptives to be sold OTC as well is the right thing to do. That decision should be made solely on safety grounds, not on grounds of political convenience. This is the same argument we make against things like forced ultrasounds for abortion patients, and it’s the right one For people who are lucky enough to have access to decent insurance, this is a muddled win. For women without access to decent insurance, this is a significant improvement to the status quo. It definately lowers the barriers to accessing birth control for some more women which is a win as they won’t have to see their ObGyn or PCP to get a prescription. However, if the drugs are being sold over the counter, most insurance companies won’t pay for over the counter medication of any sort. Further more, women can’t use their tax advantaged health savings dollars to spend on over the counter medication of any sort. Reimbursement for OTC medications only occur when their is a prescription. OTC medications will be more costly than zero cost-sharing birth control for women with health insurance. Once we start factoring in a prescription is needed for reimbursement, the cost barrier that reimbursement knocks down is replaced by accessing a provider to write the scrip. The real winners of this policy would be women without health insurance, so that increasingly means immigrant women. Increased access to birth control for this group is a win. The political downside is that putting hormonal birth control OTC gives anti-choice, anti-contraceptive politicians another angle of attack against including contraception as a core, Essential Health Benefit in any and all insurance policies as it is available over the counter. Senator Gardner (R-Co) used making birth control OTC as a dodge against all of his anti-contraception policy views in the last election. Getting a policy victory at the cost of a political club is the downside of the deal. But it is a policy victory that benefits marginal members of the community while not harming others.
The other part of the policy change that stretches a birth control prescription from once per quarter to one per year is a pure policy win on cost, effectiveness, barrier lowering and efficiency grounds.