States Paving the Bipartisan Road on Hormonal Contraceptive Access
“As gridlock deepens in Congress, only gloom is bipartisan,” the New York Times recently observed. While this sardonic characterization isn’t far from the truth, the American political system isn’t irrevocably broken. In fact, there’s a widespread appetite to unite and achieve commonsense solutions. This is perhaps most evident in state legislatures, where concepts like nonpartisanship and real compromise are still alive and well — even with traditionally controversial issues like reproductive health.
It’s perhaps an understatement to say that the political left and right have taken different approaches to women’s health care. While stereotypes are always imperfect, liberals often demand reproductive choice and increased access to contraceptives, sometimes even heavily subsidized by taxpayers.
Meanwhile, conservatives generally focus on preserving the life of the unborn and reducing government spending. However, there’s a grand compromise that can work toward each of these goals: permitting a freer birth control market. By reorienting the prevailing models of hormonal contraceptive access, states can expand women’s health care access and limit unplanned pregnancies, all while reducing patient costs, cutting red tape and lowering the taxpayer burden.
In most states, women must jump through several hoops to obtain birth control. First, they have to set aside time to visit a physician. For many, this includes an expensive copay, and for those without insurance, the visit can cost between $35 and $250. At the medical visit, they are required to self-report their medical history and submit to a blood pressure check. Only after doing so can they receive a prescription, which they can only fill by visiting a pharmacist.
These requirements create unnecessary barriers to obtaining health care. Many women cannot afford the time and financial costs associated with visiting a doctor for basic hormonal contraceptives. Hosts of others, primarily in rural areas, simply don’t have easy access to doctors at all. The United States is suffering from a worsening doctor shortage, and some places like Mississippi have an incredibly low physician-to-patient ratio. What’s more, half of U.S. counties are without a practicing OB-GYN.
The outdated physician access model compounds these issues, creating devastating results. In fact, in the United States, 45 percent of pregnancies are unplanned and 42 percent of these pregnancies end in abortion. There’s also a 20 percent teen pregnancy rate. Every one of these pregnancies comes at a high cost not only to mothers, but to taxpayers as well. In fact, the public funded the medical costs associated with 51 percent of pregnancies, to a tune of $40 billion in 2010 alone.
Pregnancy in America can be a millstone around the necks of taxpayers, and an unplanned one can fundamentally alter a woman’s life. Yet if women had easier access to contraceptives, these negative side effects could be greatly reduced.
Many lawmakers on both sides of the aisle have realized this. Those in both red states, like Tennessee and Utah, as well as blue states, like Oregon and Vermont, have enacted what’s known as the pharmacy access model, which permits women to safely obtain hormonal contraceptives from a pharmacist without first seeing a doctor.
This new paradigm is taking the country by storm. Ten states and the District of Columbia have already enacted the pharmacy access model, while no less than eight other states — including Arkansas, Missouri, South Carolinaand Massachusetts — are considering adopting similar models. And why not? Pharmacists are qualified to identify any possible contraindications after listening to women’s self-reported medical histories and to take their blood pressure before recommending medication. There is no need for a physician to act as the middleman between a patient and a pharmacist in these scenarios.
The truth is that expanded access would provide greater health care options, limit unintended pregnancies, eliminate burdensome regulations and reduce the taxpayer burden. In fact, the American College of Obstetricians and Gynecologists agrees that women should have easier access to birth control, and has even called for the federal government to make hormonal contraception available over the counter.
U.S. Supreme Court Justice Louis Brandeis called states “laboratories of democracy,” and indeed they are. From a birth-control access perspective, states are proposing innovative solutions to old problems and are succeeding in areas that the federal government has neglected.
Congress may be mired in a partisan logjam, but state legislators have demonstrated that not only can liberals and conservatives implement good policy, they can do so by shedding petty partisan ties and reaching across the aisle. While the federal government founders, the states can and will lead the way; the birth-control debate is just one example of this principle in action.
