Opinion: We need government to act now to expand birth control pill access

Published 11/3/2022 6:00 a.m. EDT, Updated 11/3/2022 10:15 a.m. EDT

Photo collage of two young women behind a circular pill pack of birth control and a ripped-up prescription form

In October, the Food and Drug Administration postponed an advisory committee meeting to hear and review testimony as it considers allowing birth control pills to be sold over the counter. This delay is deeply frustrating. Every day we wait is a day longer that barriers to contraception remain in place.

While over-the-counter birth control pills would be a first in the United States, we would be following the pathway of more than 100 other countries. We would also be following the recommendations of a long list of organizations representing health care practitioners, including the American College of Obstetricians and Gynecologists, the American Medical Association and the American College of Nurse-Midwives. Government action is long overdue. Over-the-counter birth control pills need to be available now.

The Maryland General Assembly anticipated years ago that birth control pills could be available over the counter. In 2016, Maryland became the first state to require health insurance to cover over-the-counter birth control with the Maryland Contraceptive Equity Act. We knew that the clinical evidence would one day demonstrate the safety and efficacy of an over-the-counter pill. As legislators, we wanted to be sure that health insurance policy followed the science. If the FDA determined a birth control medication was safe for over-the-counter use, then health insurance should cover it.

I was the lead sponsor of the Maryland Contraceptive Equity Act, along with Sen. Delores Kelley, D-Baltimore County. The legislation had many important components, but over-the-counter coverage was most important to me. It was because I knew that over-the-counter birth control had the potential to transform so many lives, particularly for people who face barriers to care, including people of color and people working to make ends meet.

We fought hard for the over-the-counter coverage provision. Sometimes, it is difficult to be the first state to pass legislation, but it was worth it. Now, more states have over-the-counter coverage requirements.

Coverage of over-the-counter birth control is critical. Just because a birth control pill might soon be available over the counter, it might not be accessible to everyone because of cost. But luckily, we have worked hard in this country to expand the number of people with insurance through the Affordable Care Act as well as many state initiatives. So, we don’t have to look far for a solution to ensure an over-the-counter birth control pill is accessible. Health insurance, whether public or private, should provide over-the-counter birth control coverage — it is as simple as that. Any over-the-counter birth control pill must be affordable, fully covered by insurance and available to people who need them, regardless of age and background.

When I think about the availability of reproductive health across our country, I shudder. But there are some bright spots, and the promise of over-the-counter birth control is one of the brightest. It will allow people to more fully control their reproductive choices. Now, we need to do our part by ensuring that form or birth control will be available and that it will be covered by health insurance.

Ariana B. Kelly, a Democrat, represents Montgomery County in the Maryland House of Delegates, where she is vice chair of the Health and Government Operations Committee.

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