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Thursday, April 9, 2020  Spokane, Washington  Est. May 19, 1883
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Opinion >  Editorial

Editorial: Increase birth control access

To amend an old joke: Are birth control pills tax deductible? Only if they’re not taken.

Unfortunately, our country erects unnecessary barriers to women who need access to contraception. The result: a high number of unwanted pregnancies.

The American Congress of Obstetricians and Gynecologists recommends birth control pills be sold over the counter. In failing to do so, the United States is out of step with many modern nations.

But as often is the case with change, lawmakers have to act incrementally to make any progress. And that’s true in Olympia, where two bipartisan bills are being pushed to increase access to oral contraceptives.

HB 2465 and SB 6369 (identical bills) would require health insurers and government health care plans to cover a 12-month supply of birth control pills with one visit to a pharmacy. The standard supply amounts are one or three months.

Meanwhile, HB 2681 would allow adult women (ages 18 and older) to get their pills from a pharmacist without getting a doctor’s prescription. The pharmacists would need some training. Women would need to complete a risk assessment and visit a physician at least once every three years.

These bills fall short of the medical experts’ recommendation that birth control pills be sold over the counter, but that goal is more likely to become a reality once it’s demonstrated that wider access achieves positive outcomes.

It’s unfortunate that such hand-holding is necessary to allay unfounded fears, but political support is lacking for over-the-counter sales. No state has taken that step, though Oregon and California have passed laws to allow pharmacists to dispense without a doctor’s signature. Oregon is the only state to require insurance coverage of a 12-month supply.

Researchers at the University of California, San Francisco found that a year’s supply of pills reduced the odds of an unintended pregnancy by 30 percent. The odds of an abortion decreased 46 percent.

The key, it seems, is uninterrupted access.

“Women need to have contraceptives on hand so that their use is as automatic as using safety devices in cars,” said Dr. Diana Greene Foster, lead author and associate professor in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences.

Forcing women to make and wait for doctor appointments raises the odds of an unintended pregnancy. For instance, college-age women may not be able to make it home to their regular physicians. Finding a new doctor can be discouraging.

The UCSF researchers estimated that among the 65,000 women in their analysis, almost 1,300 publicly funded pregnancies and 300 abortions would have been averted if the women had an uninterrupted supply of birth control pills.

These bills have elements that should please anti-abortion lawmakers, fiscal conservatives and those supportive of reproductive freedom. That’s why they have bipartisan support.

Hopefully, enough to pass.

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