Policy Studies Competition Policy

Birth control in the states: A review of efforts to expand access

Courtney Joslin
Resident Fellow and Senior Manager, Competition Policy
Steven Greenhut
Resident Senior Fellow and Western Region Director, State Affairs

Key Points

The FDA’s bureaucratic approval process, even for something as widely used and studied as hormonal birth control, remains an impediment to the best solution: over-the-counter access to birth control.

Many states are moving ahead with useful reforms that allow pharmacists to prescribe birth control after an inexpensive and noninvasive exam.

Pharmacy access removes a commercial-freedom barrier and allows women – especially low income and vulnerable women – to have easier access to birth control.


Discussions about hormonal contraception often veer of into important but tangential issues such as abortion, sexual morality and healthcare funding. But there is a needed debate about this topic that can avoid almost all of the controversy. It centers simply on access—on practical ways to remove government regulatory barriers that make it difficult and unnecessarily costly for women to readily purchase birth-control products. Hormonal birth control dramatically reduces unintended pregnancy rates and expands a woman’s autonomy to choose her family planning methods. Not surprisingly, then, there should be plenty of common ground to pursue simple measures that make it more easily available. And, as in many policy areas, the states are already leading the way.

Press release: R Street policy study: Allow pharmacy access of birth control for better women’s reproductive health and improved consumer choice

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