The Oregon legislature is considering a proposal to let pharmacists prescribe birth control pills, thereby obviating the need for a doctor's visit before obtaining oral contraception. The measure, introduced by state Rep. Knute Buehler (R-Bend), would allow patients 18 and older to fill out a self-screening tool at the pharmacy counter, get a prescription from the pharmacist, and then pick up their pills all in one easy visit. "It just seemed unreasonable that [pharmacists] can't dispense preventive contraception," Rep. Buehler, who is also a physician, told The Oregonian.
Major medical associations agree that there's little risk in making oral contraception available over-the-counter. Buehler's proposal doesn't quite go that far, but removing the requirement to visit a physician for birth control pills is a big step in the right direction. As it stands, women seeking the pill must make regular doctor's visits—usually annual, but sometimes more frequently—in order to get it, even if they've been taking the same medication for years. Requiring this annual permission slip not only wastes women's time and needlessly drives up health care spending, it inhibits responsible family planning. For women without health insurance, a flexible work schedule, etc., seeing a doctor can be prohibitively difficult or expensive. And even when cost isn't an issue, it may takes weeks to get an appointment with a OB-GYN.
During the 2014 elections, several Republican politicians spoke out in favor of over-the-counter birth control. Women's groups formerly in support of the plan began objecting, insisting that it would undermine the Affordable Care Act's requirement that health insurance plans offer "free" birth control. But even with the contraception mandate in tact, over-the-counter pills could be beneficial by providing options for those who (for whatever reasons) can't or don't want to see a doctor and involve health insurance.
Since taking office, those GOP champions of open-access contraception have been pretty silent on the issue—perhaps because it's not pressing, perhaps because it's no longer politically useful. But there's also not a ton they can do about birth control's prescription status, which would require a reclassification by the U.S. Food and Drug Administration (FDA). And in order to trigger the FDA's reconsideration, a pharmaceutical company that makes birth control pills must file a request—something drugmakers have no profit or political motive to do.
So maybe Oregon Rep. Buehler's idea—keep the prescription requirement, but make it much easier to get a prescription—is actually the best way forward here, then. Currently California is the only state where "on demand" birth control prescriptions from pharmacists are allowed.
The Oregon proposal, however, would also allow pharmacists to "choose not to prescribe and dispense" birth control pills "for ethical, moral, or religious resasons." Politically impossible as it may be, getting the gatekeepers out entirely by making the pill available over-the-counter is probably still a worthy end goal—and one that enjoys 70 percent of Americans' support.
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