Converge Submits Comment on Insurance Coverage for Contraception Provided Over the Counter.

December 5, 2023

Comment for Insurance Coverage of Over-the-Counter Oral Contraception

Thank you for this opportunity to share information regarding the need for insurance coverage for over- the-counter (OTC) contraception. Equitable access to contraception is critical now more than ever, particularly due to the recent overturning of Roe v. Wade, which secured individuals’ right to abortion access. This devastating loss to reproductive autonomy has even further limited individuals’ ability to self-determine how and when to raise child(ren), a core principle of Reproductive Justice. Provision of OTC contraception without a prescription or cost-sharing is the next step in ensuring equitable access to contraception and supporting reproductive autonomy and Reproductive Justice.

Previous research conducted by Sundstrom and colleagues supports a robust body of research indicating individuals face barriers to receiving a prescription for contraception including time, transportation, cost, stigma, embarrassment and clinician refusal on the basis of religion. These barriers are particularly heightened in rural communities, communities or color, and LGBTQ+ identifying individuals. I have experienced these barriers firsthand, being from the South, a conservative geo-political climate that undermines and discourages comprehensive sexual education, leaving me with little knowledge of my contraceptive options. Further, as an individual who grew up without health insurance, requiring a prescription for contraception incurred additional costs associated with my method choice by requiring a physical exam.

These barriers are echoed by my colleague:

“Growing up as a young person in the Mississippi Delta, sex education was non-existent. Most of the information I received was from my peers, which often consisted of myths, half-truths, and a lot of horrific traumatic experiences they encountered. The lack of sexual education resources and deep generational trauma associated with sexual reproduction in the Black communities of the Delta gave me the courage to become an advocate for many young people who looked just like me.

It’s remarkable that we’ve come to the point in our country where we are prioritizing access to sexual reproductive products. OTC [contraceptive] pills being available in communities all across the US means removing one of the many barriers that so many people face just to get access to a medication. It would be a significant setback to require a provider prescription for these products. We have a duty to offer more access to contraceptives, especially after the overturn of Roe v. Wade and how that decision has fractured the progression of choice and freedom in our country. The ask is simple: make OTC [contraceptive] pills affordable and accessible to ALL people.”

In sum, providing insurance coverage for OTC preventive products without requiring a prescription can remove barriers to access, empower autonomy in healthcare decisions, and it make it affordable for individuals with and without insurance. Providing insurance coverage for OTC preventive products is a proactive approach to reducing additional related healthcare costs and can potentially decrease the financial burden on both individuals and the healthcare system. By discussing the importance of affordable access, patient autonomy, and the potential for cost savings that result from insurance coverage for over-the-counter preventive products, we can begin to unpack similar upstream factors that improve outcomes and reduce barriers in other areas of healthcare as well.