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Media outlets are reporting that birth control is now available over the counter without a prescription in Oregon and, also be in California in a few months! Here’s why those headlines are slightly misleading and why it’s important to be really clear about what we’re talking about.
First, “over the counter” means different things in different places. Here in the US, it generally refers to anything you can buy at a pharmacy right off the shelf without needing a prescription. I noticed when I lived in London that there it generally referred to any item you didn’t need a prescription for but that the pharmacist had to supply to you. Hence, “over the counter.” Points to the Brits for clarity on that one.
In the case of birth control in Oregon and California, it’ll actually be the latter, British definition of “over the counter.” Birth control pills won’t be sold next to the Tylenol and deodorant for you to browse at your leisure. They’ll be behind the counter, and to get them you’ll have to fill out a health questionnaire that the pharmacist will evaluate before recommending you a particular type of birth control, which could be pills, or a patch, or a ring. In other words, you’ll still need a prescription, but you can now get that prescription from the pharmacist instead of your doctor.
So why is that detail so important? Well, for a few reasons. Number one, hormonal birth control comes in a variety of forms that have a variety of risks and side effects, and it’s still helpful to get a professional’s advice.
Number two, pharmacists can opt out of prescribing you the birth control due to their religion. They have to recommend you to another pharmacist, but still, that’s really fucking annoying because it still means that you could go to the pharmacist and end up not getting your birth control. As a reminder, if you’re an atheist cashier at walgreen’s and you refuse to sell someone a Bible due to your religious objections, you’ll probably be fired.
And the third reason why the details are important is that if birth control pills were able to be sold without a prescription, that would be a big win for the Religious Right, because under the Affordable Care Act, insurers would no longer be mandated to pay for 100% of the cost of that healthcare. That’s something the Religious Right has been fighting very hard, and one of their planned end-arounds is to make birth control available off the shelf, thus forcing all women to pay for 100% of the cost of it.
But that’s not what this is: the birth control still requires a prescription, and so it still falls under the ACA’s guidelines.
So that’s what you need to know. I do think this step is a win for women, though ultimately I’d like to see everyone have improved access to their doctors for a full range of preventative health, and I’d also like for the law to mandate that all pharmacists everywhere do their fucking job.