Policy Studies Competition Policy

The Devil Is in the Details: Reviewing OTC Birth Control Efforts in Congress and Their Potential Impacts


Courtney Joslin
Resident Fellow and Senior Manager, Competition Policy
Sophia Heimowitz
Research Associate, Competition Policy

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Expanding the OTC contraceptive market can broaden access, improve consumer choice, drive down costs and allow women to make the contraceptive decisions that work best for them.


With the reproductive health landscape taking center stage in the political arena once again, many are looking for ways to improve access to contraception. Concerns over access for the millions of women who rely on birth control are bipartisan; in recent years, both Republicans and Democrats in Congress have introduced their own legislation that aims to improve access to hormonal birth control through over-the-counter (OTC) availability.

Although policymakers from both parties believe that hormonal birth control, such as the pill, should be available OTC, they disagree on insurance coverage. A recent proposal from Democrats in Congress would mandate that, if a birth control pill were to become available OTC, it must be fully covered by insurance. Their Republican counterparts opposed this and have offered their own solutions that stop short of full insurance coverage. Putting the full-or-no insurance coverage debate aside, proposals in Congress that aim to fast track an OTC birth control pill are worth examining for their potential impact.

This paper explores proposals in Congress’s recent past from Republican members that urge the U.S. Food and Drug Administration (FDA) to fast track an OTC pill option, as well as the potential cost implications of those proposals to consumers. With this information, policymakers will be able to work toward bipartisan solutions.

Read the paper, “The Devil Is in the Details: Reviewing OTC Birth Control Efforts in Congress and Their Potential Impacts.”