• Facebook
  • Twitter
  • Subscribe
  • RSS

Bobby Jindal: Sell Birth Control Over The Counter

Louisiana Governor Bobby Jindal’s pro-life bona fides are beyond question, so he’s raised some eyebrows today with an Op-Ed in The Wall Street Journal calling for birth control pills to be sold over the counter:

As an unapologetic pro-life Republican, I also believe that every adult (18 years old and over) who wants contraception should be able to purchase it. But anyone who has a religious objection to contraception should not be forced by government health-care edicts to purchase it for others. And parents who believe, as I do, that their teenage children shouldn’t be involved with sex at all do not deserve ridicule.

Let’s ask the question: Why do women have to go see a doctor before they buy birth control? There are two answers. First, because big government says they should, even though requiring a doctor visit to get a drug that research shows is safe helps drive up health-care costs. Second, because big pharmaceutical companies benefit from it. They know that prices would be driven down if the companies had to compete in the marketplace once their contraceptives were sold over the counter.

So at present we have an odd situation. Thanks to President Obama and the pro-choice lobby, women can buy the morning-after pill over the counter without a prescription, but women cannot buy oral contraceptives over the counter unless they have a prescription. Contraception is a personal matter—the government shouldn’t be in the business of banning it or requiring a woman’s employer to keep tabs on her use of it. If an insurance company or those purchasing insurance want to cover birth control, they should be free to do so. If a consumer wants to buy birth control on her own, she should be free to do so.

Over-the-counter contraception would be easier to obtain if not for some unfortunate aspects of President Obama’s health-care law. One of the most egregious elements of that law is the hampering of Health Savings Accounts, which have become increasingly popular in recent years because they give Americans choices in how to spend their money on health care. By removing the ability of citizens to use their HSAs to purchase over-the-counter medicine tax-free if they don’t have a doctor’s prescription, President Obama hurt many middle-class families who counted on using their HSA dollars every flu season to take care of their children. Health Savings Accounts should cover over-the-counter purchases, and those should include contraception.

It’s time to put purchasing power back in the hands of consumers—not employers, not pharmaceutical companies, and not bureaucrats in Washington. The great thing about America is that power doesn’t come from government, but from people. It’s time to reclaim that power. It’s time to stop government from dividing people or insulting deeply held religious beliefs, and return the country to the path that has always made it great—one where Americans respect and value their fellow citizens, no matter their creed.

Kevin Drum calls this is a smart play on Jindal’s part:

Jindal understands that, like it or not, Democrats were quite successful at demagoguing Republicans this year over their opposition to the contraception mandate. And yet, the Republican base is still dead set against the idea that “religious institutions” should be required to pay for contraceptives for their employees. How to square this circle?

Easy: if contraceptives are sold over the counter, then the issue disappears. Insurance doesn’t usually cover non-prescription drugs, which means the mandate goes away. No employer-provided insurance plan will have to cover contraceptives, so the whole fight over religious objections evaporates.

What’s more, smart liberals would probably support this idea too, for several reasons. First, the evidence suggests that oral contraceptives are safe enough to be sold OTC. So it’s good public policy in general. Second, the cost of contraceptives would almost certainly drop substantially if this happened. They’re cheap to manufacture, after all. Third, all things considered, OTC availability would probably make contraceptives more available and more widely used than prescription contraceptives subsidized by insurance companies.

This is why I said Jindal is smart. He’s picked an issue that has good scientific backing, offers a strong chance of bipartisan support, and eliminates an emotional fight that conservatives are losing. It also gives him some street cred as a guy who wants to turn down the temperature on the culture wars. Not bad.

I largely agree that this is a politically smart move for Jindal, but beyond the politics this strikes me as very good policy. It was less than a month ago that the American College of Obstetricians and Gynecologists formally endorsed the idea that birth control pills should be sold over the counter, arguing that the pills themselves are generally safe enough to be sold over the counter and that wider availability of birth control would go a long way toward cutting down on unintended pregnancies, something that should appeal to both the left and the right in the end. Obviously, it would be unwise for this OTC policy to apply to children, largely because of the fact that teenagers are going through hormonal changes that arguably make it advisable that they be under a doctor’s supervision when taking what essentially amounts to hormone therapy. Additionally, this would be another of the many areas where the rights of children are circumscribed because they aren’t fully able to make decisions for themselves. For adult women, though, I don’t see any reason why they should need to get a doctor’s prescription for birth control.

Related Posts:

About Doug Mataconis
Doug holds a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May, 2010 and also writes at Below The Beltway. Follow Doug on Twitter | Facebook

Comments

  1. Tony W says:

    Yes, this is an excellent way to assure the working poor cannot obtain birth control, even when they have prescription coverage.

    Like or Dislike: Thumb up 6 Thumb down 4

  2. Franklin says:

    He doesn’t suggest banning prescription coverage for birth control, just making it optional. If your plan doesn’t cover it, get a different plan or have more oral sex or something. The government can’t take ALL the responsibility, certainly people can take a little bit.

    Like or Dislike: Thumb up 1 Thumb down 11

  3. Tsar Nicholas says:

    Here’s the real money quote from that piece by Jindal, literally and figuratively, but which for obvious reasons won’t receive too much attention from the usual suspects:

    One of the most egregious elements of [Obamacare] is the hampering of Health Savings Accounts, which have become increasingly popular in recent years because they give Americans choices in how to spend their money on health care. By removing the ability of citizens to use their HSAs to purchase over-the-counter medicine tax-free if they don’t have a doctor’s prescription, President Obama hurt many middle-class families who counted on using their HSA dollars every flu season to take care of their children. Health Savings Accounts should cover over-the-counter purchases, and those should include contraception.

    Indeed. Obamacare does a lot of screwy things. But reducing consumers’ ability to buy cheaper drugs OTC it near the top of the dunce heap. And the law’s antipathy towards HSAs not only is short sighted and self-defeating it’s nearly pathological. It’s straight out of political Bizarro Land. Sorry, folks, but you have to use post-tax new dollars to buy that OTC pill as opposed to pre-tax dollars you’ve already saved up. And if you really and truly want to buy the OTC version of some medicine with your HSA money you first have to spend more money on seeing your doctor and getting a prescription for it. Big government gone loco.

    In any event, Jindal is no dummy and his ideas all around make a lot of sense. Ironically enough, however, these viewpoints will be major negatives for him should he decide to run for Prez. The GOP primary selectorate largely consists of irrational thumpers, and on topics such as birth control you simply can’t talk sense to them.

    Like or Dislike: Thumb up 2 Thumb down 5

  4. swbarnes2 says:

    Astonishing! An honest -to-God policy presented by a Republican, and one of the front-pagers actually wants to talk about it! I never thought I’d see the day.

    Yeah, sure making those contraceptives which are safe for OTC OTC would be great, but

    1) not all contraceptives are. I bet not all pill formulations are.

    2) Health care is part of employment compensation for most people. That means employers should not be allowed to tell employees how to manage their health, any more than they tell them how to spend their paycheck. Taking contraception out of employee-sponsored health care to appease overweening employers is wrong.

    Highly-rated. Helpful or Unhelpful: Thumb up 17 Thumb down 2

  5. grumpy realist says:

    @Franklin: then why do standard health care plans cover the-little-blue-pill-that-must-not-be-named?

    It seems to me that birth control for women is far more important in regards to actual health than the stuff for men. But what do the religious nuts go bananas about? birth control

    Like or Dislike: Thumb up 5 Thumb down 0

  6. Rob in CT says:

    Let’s do it, and subsidize it to boot. :)

    I would like to hear from some medical professionals about The Pill in particular. My understanding is that there are different formulations of it and it might just be a good idea to have a dr. involved in the process of selecting the right one for you.

    I’m all for readily available BC. I think it’s great. That concern just jumped out at me, though…

    Like or Dislike: Thumb up 1 Thumb down 0

  7. edmond says:

    Sigh….I supposeif this came to pass then he 2016 Republican presidential debates will focus on which candidate will shut down the most pharmacies if he’s elected

    Like or Dislike: Thumb up 1 Thumb down 0

  8. James Joyner says:

    @Tony W: But lots of once-prescription-only meds have gone OTC and thus aren’t covered by insurance. A lot of pain and allergy meds fall into that category. For that matter, condoms are sold OTC and thus not covered by insurance. So, assuming that they’re safe for OTC sale, why not birth control pills?

    @grumpy realist: This has always struck me as a red herring. ED drugs are designed to correct a health problem; i.e., the body not working optimally. BCPs, at least when prescribed for their original purpose, are designed to prevent the body working the way it’s supposed to. Now, I’m in favor of cheap and easy availability of contraception. But I don’t know why insurance should cover it. (There are also, of course, non-BC uses for the pills, which would fall into the standard sort of treatments insurance was designed to cover.)

    Like or Dislike: Thumb up 1 Thumb down 3

  9. swbarnes2 says:

    @grumpy realist:

    It seems to me that birth control for women is far more important in regards to actual health than the stuff for men. But what do the religious nuts go bananas about? birth control

    So much Republican and conservative policy flows from the premise that half the species are no more than inconveniently sentient incubators/sex outlets.

    It’s only rape if the outlet is “shredded”, for example. Otherwise, everything is fine. I mean, threatening to incinerate a toaster isn’t a crime, right?

    Like or Dislike: Thumb up 2 Thumb down 0

  10. aFloridian says:

    @Tony W, so by not requiring prescriptions for acetaminophen and ibuprofen are we in effect depriving the working poor from access to those drugs as well?

    There is a undercurrent in some of the comments here that suggests to me that either a general hatred of Republicans or this stupid fight about birth control and religious institutions (I don’t see why BC SHOULDN’T be covered by insurance in general, and while I understand the argument of the religious organizations I have a hard time sympathizing) is obscuring the fact that allowing birth control to be sold over the counter could do nothing but increase the availability. Especially to the poor and to minorities who may not be able or willing to visit a clinic or physician’s office but will certainly visit a Walmart or other market regularly. Consider: If condoms required a prescription today would they be as widely used? I think not.

    Like or Dislike: Thumb up 2 Thumb down 0

  11. swbarnes2 says:

    This has always struck me as a red herring. ED drugs are designed to correct a health problem; i.e., the body not working optimally. BCPs, at least when prescribed for their original purpose, are designed to prevent the body working the way it’s supposed to.

    Oh yes, the Platonist telling women how their bodies are supposed to work.

    Is your body supposed to have antibodies against microbes that you’ve never encountered?

    Have you ever taken an anti-inflammatory medicine, like aspirin?

    Like or Dislike: Thumb up 7 Thumb down 1

  12. Sirkowski says:

    Do I need a prescription for an exorcism?

    Like or Dislike: Thumb up 3 Thumb down 0

  13. rudderpedals says:

    Prescription->OTC for a lot of things would be more palatable if it actually as opposed to theoretically lowered the expense, was of good quality, and was available. But the invisible hand too often isn’t spending time goading better market competition because it’s off picking the patient’s pocket with IP games, missing q/a, phony testing, and market manipulation worthy of a Teddy Roosevelt era trustbuster.

    Like or Dislike: Thumb up 1 Thumb down 0

  14. Peacewood says:

    @James Joyner: Except that there are genuine medical reasons for BC to be prescribed, up to and including menstrual bleeding. One of my exes took BC since puberty for this very reason. These cannot and should not be hand-waved away under a “birth control” rubric.

    Like or Dislike: Thumb up 5 Thumb down 0

  15. swbarnes2 says:

    @Peacewood:

    Except that there are genuine medical reasons for BC to be prescribed,

    I really hate the framing that not wanting to be pregnant is not a legitimate medical need. Sex is a normal part of human life, but I think conservatives think it’s too good for poor people to have, hence their seething desire that women who engage in it should be punished by having to face serious consequences that in a sane country with proper health care would be easily avoidable.

    And honestly, we already know that the “not all birth control us used by sluttly sluts” won’t fly in conservative circles, so why bring it up? Sandra Fluke’s friend was trying to avoid getting cysts the size of tennis balls in her body, but did you hear one Republican say “Oh sh*t, she shouldn’t have had to go through that just because her medication was also birth control!”

    Like or Dislike: Thumb up 11 Thumb down 1

  16. aFloridian says:

    I never understood the “slut” misogyny. It really must just be hatred of sex and a desire to impose a Puritanical outlook (like Limbaugh believes a word of that) on others.

    In my view, it is the negative social consequences of unplanned, unwed, or teenage that are harmful. Why would any true conservative or liberal NOT want to make birth control, condoms, and other items available to the promiscuous. I don’t care if you have a different sex partner every night, but I’d feel a lot better knowing that people were making the right choice (and had access to) effective contraception. I don’t like unnecessary abortions. I would be very happy to see fewer abortions. Do I think abortion should be illegal or that access should be so restricted (looking at you Mississippi) that women have to walk a tight rope and be degraded as they walk into a clinic? No! It’s precisely because of this that I am such a strong believer in sex education and contraceptives.

    I’m thinking about the children.

    Like or Dislike: Thumb up 5 Thumb down 0

  17. Jc says:

    You can already buy birth control over the counter. They are called rubbers

    Like or Dislike: Thumb up 1 Thumb down 6

  18. An Interested Party says:

    Why would any true conservative or liberal NOT want to make birth control, condoms, and other items available to the promiscuous.

    Because too much sex leads to Sodom and Gomorrah…oh, and no one else should have to subsidize the cost of making sure that sex doesn’t produce a baby…oh, and no one should have sex just for the pleasure of it–sex is for procreation…I’m sure the usual suspects can come up with more arguments along those lines…

    Like or Dislike: Thumb up 0 Thumb down 2

  19. anjin-san says:

    ED drugs are designed to correct a health problem; i.e., the body not working optimally.

    Perhaps that is the original intent of the drugs, but in reality they are used, by in large, to allow middle aged guys who are not impotent to perform in bed like 20 year olds.

    Like or Dislike: Thumb up 4 Thumb down 1

  20. Just Me says:

    Allergy meds, refulx meds, Aleve, and others have all gone OTC over the last 10 years or so.

    BCP’s come with some risk, but seems like they aren’t any more risky than some of the other newer OTC meds. Seems like making them available makes sense.

    Sure insurance may balk, but given that generic BCP’s run about $10 right now (and some pharmacies like Wal-Mart charge $4), I would imagine the drugstore brands for BCP’s would be affordable-even for the working poor.

    I think it is about time they went OTC anyway, and Jindal’s arguments in favor make sense.

    Like or Dislike: Thumb up 2 Thumb down 0

  21. Argon says:

    @swbarnes2: “Oh yes, the Platonist telling women how their bodies are supposed to work.”

    You win five internets for that observation.

    James, the reason why birth control should be covered is because it’s a crucial medical need that is directly related to a woman’s *personal* health and welfare. It’s up there with regular diagnostic visits & screening, fertility treatments, and reproductive counseling.

    Another reason why we should extend coverage is economic as the timing of childbearing has tremendous impact on the future economic status of mothers and their children.

    And yes, I would include condoms on the list of covered or subsidized services.

    Like or Dislike: Thumb up 1 Thumb down 0

  22. Tamii says:

    This is absurd. Yes, birth control pills are safe. For most women. And if by safe you mean it probably won’t kill them or make them physically sick, then that statement is acurate. However, if you take into account the increased risk of depression (as well as all the emotional and physical side effects that correspond to that disease) and low libido, then I would call that statement absolutely false. Aside from the fact that this would mean any random 18 year old girl could pop into her local corner store and have to decide for herself not only whether or not she could be in the high risk group for the possible physical side effects of blood clots, stroke, and nausea in addition to the rarely mentioned possible emotional and psychological side effects and THEN have to determine herself how high her risks may be and whether or not those risks are low enough to be worth the reward is ludicrous. When altering the natural hormone levels in someone’s body, a physician needs to be consulted. Period.

    I am all for decreasing unitended pregnancies, but this is not the right way to go about it. Even if it just required a quick consult with the pharmacist to review all of those possible risk so the purchaser could be aware if she started to show any of those side effects, it wouldn’t bother me nearly as much. In my mind, and with my experience with these hormones, there is just no way this is the best way to manage the situation,

    Like or Dislike: Thumb up 2 Thumb down 0

  23. grumpy realist says:

    @Tamii: Well, remember that it used to be very easy to get the generic birth control pill at Planned Parenthood….

    The major problem I remember is that they went for the smallest possible dose which meant for some of us there was breakthrough bleeding.

    And James, I don’t think much of your argument. Not having birth control has a heck of a lot more effect on women’s health, overall, than 50-70 year old men being unable to act like 20-year-olds. I bet the actual number of men who REALLY have ED in comparison to the average sexual activity of other men of their age is low. What it really is that men think they have a God-given right to act like a horny teenager, no matter what their age.

    Like or Dislike: Thumb up 1 Thumb down 0

  24. Tony W says:

    My initial comment was rooted in reaching back in my dusty memory banks to my own old working-poor days. When cold medicines, etc. went OTC, suddenly I had to cough up spare cash for them (pun intended, he he) – or more likely just do without. I was fortunate enough to have health coverage – but not cash. My kids even went to the low-income clinic for a time, where prescription meds are available, but OTC is not.

    Perhaps things have changed for young folks today – health care coverage may not be as prolific, so this may be less of an issue.

    Like or Dislike: Thumb up 1 Thumb down 0