A representative 2015 piece in Salon by feminist writer Katie McDonough called the OTC pill push “a transparent attempt to chip away at the Affordable Care Act” that would “do very little to expand access, particularly to low-income women in rural areas.” Apparently, expanding access wasn’t really expanding access unless insurance companies were involved.
This was a dark moment in Democratic politics: Even as they ramped up efforts to portray Republicans as the harbingers of a Handmaid’s Tale scenario and to portray themselves as hip to the needs of marginalized groups, Democrats sacrificed an opportunity to help women struggling to obtain birth control prevent unintended pregnancies. Instead, at the expense of undocumented immigrants, low-income women, victims of domestic violence, and others, they opted to help middle-class women save $10 a month—and prop up insurance providers, pharmaceutical companies, and the Democratic fundraising machine in the process.
All the while, they insisted that they were putting contraception in reach for more American women. But evidence suggests they were merely shifting around costs.
Between 2013 and 2017—the years in which employers were required to come into compliance with the ACA’s contraception mandate—the percentage of women whose private plans offered no-copay contraception jumped from 45 percent to 75 percent, according to Kaiser Health. Plans covering pills with a copay dropped from 49 to 19 percent. Either way, 94 of those surveyed had employer-subsidized birth control coverage.