Bobby Jindal, who’s wooing religious conservatives ahead of 2016, has been pushing this idea since 2012. He anticipated the loophole in yesterday’s Hobby Lobby decision: Even if the feds can’t require a (closely held) corporation to cover contraception for its employees, there’s nothing stopping HHS from requiring insurers to cover it for “free,” i.e. through a cost-spreading mechanism that ropes in the wider population. That would solve the religious-freedom objection — Hobby Lobby’s money would no longer be directly applied to pay for abortifacients to which it objects — while guaranteeing that birth control remains effectively subsidized for employee. The only losers are … everyone else, now collectively on the hook for the subsidy. Jindal’s alternative: Why not boot the pill out of the realm of health coverage altogether by making it available OTC? If the morning-after pill is available without a prescription, it stands to reason that a morning-before pill should be. Costs would drop, personal responsibility would be championed, and the religious-freedom problem to all this would be solved. Congress could, as Jindal suggests, even adjust Health Savings Accounts so that they include OTC medicines, which would further reduce the financial burden. And politically, it would complicate the Democrats’ dopey “war on women” messaging by decoupling the contraception debate from the debate over abortion. How do you push a “Republicans don’t believe in reproductive freedom” message if GOPers like Jindal want to make the pill OTC?
Ben Domenech makes the policy case:
That’s one of the reasons why support for making birth control available over the counter is rising on the right and the left. There are a number of objections to this, but I find them to largely amount to unconvincing paternalism. The chief argument advanced is that standard oral contraceptives mess with hormones and have all sorts of side effects. This is, of course, true! But: dangerous side effects are rampant within all sorts of other over the counter drugs. Women can think for themselves and make decisions with their doctor and pharmacist about what drugs they want to take – and the evidence shows they are good at self-screening. In fact, it would actually increase the ability to mitigate and respond to unanticipated side effects, since changing tracks will no longer require a doctor’s visit and getting a new prescription. Assuming that women won’t or can’t take responsibility for themselves to consult with a doctor unless required to by arbitrary government policy is absurd.
It’s obvious why libertarians like the idea of OTC birth control. Conservatives should like it because it removes the responsibility for redistributive payment from themselves while demonstrating that yes, they really aren’t about banning things or preventing access to birth control. And liberals should like it because it will lower the drop-out rate, which is currently largely driven by the requirement to re-up the prescription as much as every few months. The American College of OB-GYNs supports it, Louisiana Gov. Bobby Jindal and Colorado Rep. Cory Gardner support it, most of the world already has it, and making it official policy would lower prices, lower health care costs, and make consumers more cost conscious. All of these are good things.
Philip Klein likes the politics, too:
Philosophically, it’s consistent with limited government principles. It removes unnecessary government regulations and increases choice.
It doesn’t impose new burdens on businesses or religious institutions, nor does it require an increase in government health care spending.
And politically, it would also be beneficial to Republicans. It would make it a lot more difficult for Democrats to portray the GOP as being only interested in obstructing Democrats rather than supporting their own ideas, and harder to accuse Republicans of being broadly against access to birth control…
If Democrats oppose the move, they’ll have to explain why they want to force women to go through their doctors to obtain birth control and make it harder for uninsured women to gain access.
Right, but what about the intraparty politics? The vast, vast majority of Republicans (87 percent) find birth control morally acceptable; in fact, according to a 2012 Gallup poll, the GOP numbers on that question are almost indistinguishable from independents and Democrats. A heavy majority of Catholics (82 percent) also find it morally acceptable. The potential social-con objection here isn’t to birth control itself, I think, as to the potential consequences of expanding access — more people, especially teenagers, having sex. Domenech deals with that argument by urging conservatives to face facts: Teens are already having lots of sex and the morning-after pill will be an option for them even if OTC birth control isn’t. The culture war on this point is lost. True enough, but are social conservatives willing to concede that point when they’re also losing badly on gay marriage? Seeing the GOP, ostensibly the party of “values,”suddenly trying to one-up Democrats in making access to the pill easier might be too much at this particular cultural moment. Or am I not giving them enough credit? Comments in our Headline thread for Klein’s post are mainly split between people who like the OTC idea and people who think the pill has far too many dangerous physical side effects to be sold OTC, but moral objections are a sidenote. Is this an idea that Jindal and/or other GOP contenders can get away with pushing or is it destined to become some sort of RINO/true conservative litmus test?