Rep. Alexandria Ocasio-Cortez says birth control should be available over the counter. She’s right.

(At least, if by “birth control” she means birth control pills. I presume no one, least of all the pharmacist at Walgreen’s, wants pharmacists to insert IUDs.)

Birth control pills are available over the counter in most other countries. The “morning-after pill,” better known as Plan B, is already available over the counter in America

Most American women favor making the birth control pill accessible over the counter. According to a 2017 Kaiser Family Foundation survey, three-quarters of women of reproductive age support over-the-counter access to birth control pills. 

So why hasn’t it happened? It must be that awful, religious-right-dominated GOP that’s standing in the way, right?

Actually, not so much.

Republicans, in fact, have repeatedly tried to make birth control pills available without a prescription, only to face opposition from . . . Democrats and Planned Parenthood

Why Planned Parenthood doesn't support it

Yes, you heard that right. Democrats — and Planned Parenthood — have fought against making it easier for women to get birth control pills. Why? Well, they have their reasons.

In Planned Parenthood’s case, it’s probably, according to Hadley Heath Manningwriting in Forbes, because they’d make less money. “Planned Parenthood’s stance on expanding access to birth control may be illogical in light of their mission statement, but it is perfectly logical when you consider the group’s financial interests.” Planned Parenthood brings in 1.7 billion dollars in revenue annually according to it's latest financial report and contraception accounts for 27% of the services they provide. 

If women are buying their pills at CVS, there’s no insurance money rake-off for Planned Parenthood. (And if you want to be ultra-cynical, if fewer women are on the pill — that Kaiser survey says that one in five sexually active women ages 18-44 aren’t on any birth control — then that means more abortion business for Planned Parenthood, which is, as Manning notes, America’s "number one abortion provider.") 

Why Democrats don't support it

Planned Parenthood is also a big donor to Democrats, who have worked to block over-the-counter birth control pills. And Democrats have fought hard, partly because they — and drug companies — want birth control pills to be subject to health insurance reimbursement, though only the more privileged among Americans get that. 

As Elizabeth Nolan Brown writes in Reason, “Even as they ramped up efforts to portray Republicans as the harbingers of a Handmaid's Tale scenario and to portray themselves as hip to the needs of marginalized groups, Democrats sacrificed an opportunity to help women struggling to obtain birth control prevent unintended pregnancies. Instead, at the expense of undocumented immigrants, low-income women, victims of domestic violence, and others, they opted to help middle-class women save $10 a month — and prop up insurance providers, pharmaceutical companies, and the Democratic fundraising machine in the process.”

So Rep. Alexandria Ocasio-Cortez is right that birth control pills should be available over the counter, but her idea is being blocked by a largely Democratic coalition that’s basically working to protect the interests of big businesses.  As Jillian Kay Melchior writes: “Women’s health-care choices shouldn’t be limited by the greed of special-interest groups or the political calculations of jaded congressmen.”

Will an un-jaded congresswoman, in the person of Ocasio-Cortez, be able to shake up this coalition and help Republicans pass legislation to free birth control pills from excessive regulation? Or was she just tweeting? Stay tuned to find out.