Senate candidate Thom Tillis (R-NC) became the latest Republican to endorse over-the-counter birth control access in a debate Wednesday evening. Tillis, who as the state House Speaker oversaw a slew of legislation aimed at restricting women’s health access, followed the lead of Senate candidates Rep. Cory Gardner (R-CO) and Ed Gillespie (R-VA), who have recently invoked this contraception plan to fend off attacks on their anti-woman voting records. But some women’s health advocates are suspicious of the sudden enthusiasm.
“Should all businesses be required to provide contraceptive coverage regardless of their religious beliefs?” the moderator asked. Tillis insisted that the Hobby Lobby decision “was not about contraception,” instead pivoting to over the counter birth control access.
“I actually agree with the American Medical Association — we should make contraception more widely available,” he said. “I think over-the-counter oral contraception should be available without a prescription. If you do those kinds of things it will actually increase the access and reduce the barriers for having more options for women for contraception.”
Since losing women to Democrats by huge margins in 2012, the Republican Party has been trying to figure out how to change its anti-woman image. Candidates have attended training sessions instructing them to avoid offending women and to “re-brand” their policies to sound more woman-friendly. So far, these efforts have flopped; a recent internal poll by two conservative groups found that women are “barely receptive” to Republican policies and still see the party as “intolerant” and “stuck in the past.”
The focus on over-the-counter birth control may represent Republicans’ first concrete policy pitch to women. But doctors are skeptical.
“We certainly welcome new partners who are genuinely interested in expanding women’s health,” Dr. Nancy Stanwood, a practicing OB-GYN and board chair of Physicians for Reproductive Health, told ThinkProgress. However, she pointed out, “if birth control goes over the counter without covering it, that actually hurts access.”
Physicians generally support over-the-counter access, as it could make birth control pills easier to acquire, and therefore more effective. But if the Affordable Care Act’s contraception coverage stopped short of over-the-counter pills, it could be “one step forward, two steps back,” Stanwood said. “We know that increasing access is important, but affordability is part of access,” Stanwood said.
The GOP candidates who say they support making contraception available without a prescription have not specified whether or not women would be expected to pay for pills out of pocket or if they would support requiring insurance to cover it. They have, however, applauded the Supreme Court’s Hobby Lobby ruling, which crippled the contraception mandate, as well as called for the complete repeal of Obamacare.
Stanwood noted that when other medications have gone over the counter, insurance has stopped covering it. Furthermore, candidates have only specifically endorsed birth control pills, she pointed out, which is only one of many different options and may not be the most effective method for many women. Focusing on pills while doing away with the insurance guarantee could make other options, like the more effective IUD, too expensive upfront.
Planned Parenthood, which launched a multi-million dollar campaign offensive ever this year, released a statement shortly after the debate accusing Tillis of posturing. “If Thom Tillis and others were serious about expanding access to birth control, they wouldn’t be trying to repeal the no-copay birth control benefit or cut women off from Planned Parenthood’s preventive health services,” Melissa Reed of the Planned Parenthood Health Systems Action Fund wrote. “This is simply a cynical political attempt to whitewash his terrible record and agenda for women’s health.”
Indeed, while Tillis was House Speaker, the North Carolina legislature passed some of the most radical abortion and contraception restrictions in the country. Earlier this year, a judge struck down a particularly extreme provision that required doctors to force women to look at ultrasounds of their fetuses before getting an abortion. Tillis also led an effort to defund Planned Parenthood — perhaps one reason why the women’s health organization is dropping $3 million on North Carolina.