Birth control bait-and-switch [Editorial]

Our view: GOP candidates are touting their newfound support for expanded access to contraceptives, but the ploy could backfire

September 14, 2014

In what on the surface seems like a remarkable turnaround, a number of conservative Republican Senate candidates this year are supporting a proposal to expand access to birth control by making it available without a prescription as an over-the-counter medication. Wider access to birth control traditionally has been a Democratic issue, so Republicans' sudden embrace of it seems almost too good to be true. Unfortunately, it is.

This year four GOP Senate candidates in close races against Democratic incumbents have announced their support for over-the-counter access to birth control: Cory Gardener of Colorado; Thom Tillis of North Carolina; Ed Gillespie of Virgina and Mike McFadden of Minnesota. From listening to their speeches and media ads, you'd think they'd all been struck by a Saul-on-the-road-to-Damascus moment that miraculously opened their eyes to the need for protecting women's reproductive rights.

But while the candidates are doing their best to sound as if they're now all for expanded access to birth control, the policies they espouse would do just the opposite. By making birth control available over the counter, the GOP proposal would actually make it more expensive, since it would no longer be covered by most insurance plans under the Affordable Care Act. Not only would fewer women be able to afford it, the 48 million women who now get birth control under the health care law would pay an extra $483 million a year for the medications they now receive for free.

The backdrop here is the Supreme Court's Hobby Lobby decision, which held that certain closely held corporations can refuse to provide contraceptive coverage through their employee health plans for religious reasons. That standard is understandably unpopular with women, many of whom bristle at the idea that an employer should be able to impose his or her religious views on them. Some Republican candidates have found themselves in a tough spot as a result: They don't want to alienate the social conservatives who support the Hobby Lobby decision, but they can't afford to get clobbered at the polls by the women who don't. This latest political ploy offers a clever way out: The Affordable Care Act's mandate refers specifically to prescription forms of birth control, so making the pill available over the counter, these candidates presumably figure, makes the issue go away.

"I actually agree with the American Medical Association that we should make contraception more widely available," Mr. Tillis claimed during his first debate with Democratic Sen. Kay Hagan. "I think over-the-counter oral contraception should be available without prescriptions."

That statement conveniently left out the fact that while the AMA indeed supports wider access to birth control, it carefully reserved judgment on the wisdom of making it available over the counter.

The idea of over-the-counter access to birth control as a Republican issue seems to have originated in Louisiana Gov. Bobby Jindal's 2012 GOP presidential primary campaign. Mr. Jindal recognized his party's weakness among women voters and argued that expanded access to birth control would lower prices as a result of increased competition. He also saw birth control as a gateway issue for women that could alienate a generation of voters if the GOP failed to address it — something his party's eventual nominee, Mitt Romney, discovered to his regret in the general election that year.

Republicans clearly are worried about their ability to attract women voters in this year's elections, and given their past record on women's reproductive rights it's no wonder they lack credibility on the issue. Even the most optimistic GOP strategists don't think the party can win the women's vote solely on its proposal to expand access to birth control. But that may not be necessary. The GOP ploy could be effective even if it just managed to narrow the Democrat's margin among women enough to allow its candidates to eke out a victory.

Yet there are risks to that strategy as well. By raising the issue of birth control just before an election, Republicans could also remind voters of their previous opposition to women's reproductive rights, including abortion, in a way that rallies them to come out in even greater numbers against the party's candidates. Indeed, some Democrats think the GOP is playing right into their hands by making expanded access to birth control a signature issue in the campaign. If that's true, the more Republicans talk about birth control the better chance Democrats have of winning.

This should not be a political issue at all but one that is based on science. Birth control pills now have a long track record of safety, but they also can produce side effects, which is why they have continued to be available only through a doctor's prescription. If that standard is to change, let it be because the medical community has concluded that the risks posed by birth control pills are of a magnitude similar to other medications that are sold over-the-counter, not because some political candidates see it as an easy way around the issues posed by the Hobby Lobby decision.


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