Sen. Kelly Ayotte (R-NH) wants you to believe that she is a different kind of Republican. She’s totally cool with all that non-babymaking sex you are having.
— Josh McElveen (@JoshMcElveen) October 3, 2016
For what it is worth, Ayotte’s endorsement of condom use does place her well to the left of her party’s vice presidential nominee. In a 2002 interview, then-Rep. Mike Pence (R-IN) attacked Secretary of State Colin Powell for endorsing condom use, labeling it a “sad day” and claiming that Powell should have reaffirmed “this president’s commitment to abstinence as the best choice for our young people.”
Nevertheless, though the free Ayotte Prophylactics and the senator’s “commitment to making birth control available over the counter” appear to demonstrate that Ayotte is a hip, centrist Republican who wants to make it easier to obtain contraception, the reality is quite different. Simply making birth control available over the counter, without making other significant changes to existing law, will do little to promote access to contraception.
Currently, the Affordable Care Act requires insurers to cover contraception regardless of whether that contraception is obtained from a pharmacist or purchased over the counter. Insurers are only required to cover birth control, however, if it is prescribed by a medical professional. Thus, allowing women to purchase birth control over the counter will make such purchases only marginally more convenient, since women will still need to go through the hassle of seeing a doctor and obtaining a prescription.
In 2014, many Republicans were under fire from Democrats because of the GOP’s enthusiastic support of Burwell v. Hobby Lobby, a Supreme Court decision placing employers with religious objections to birth control ahead of many employees who wish to use contraception. Faced with this criticism, Sen. Ayotte responded with legislation which would have eased the process of making prescription contraceptives available over the counter.
Yet, while her bill may have made it easier to purchase birth control without having to go to the pharmacy desk, it did not address the problem that insurance will not cover birth control unless the woman has a prescription. Indeed, many women’s health groups feared that Ayotte’s bill could increase the cost of birth control for many women by causing them to pay for birth control over the counter instead of obtaining free contraception with a prescription.
As the American Congress of Obstetricians and Gynecologists said in a statement, Ayotte’s bill “would actually make more women have to pay for their birth control, and for some women, the cost would be prohibitive.” (It’s worth nothing that a separate bill, co-sponsored by 32 Democrats and one Republican, would require insurers to cover over the counter birth control without a prescription. Ayotte is not one of the co-sponsors of this bill.)
To be clear, over the counter access to birth control is widely supported by many leading health organizations. But the way to make birth control available over the counter is to make it available in a way that neither makes contraception more expensive nor requires women to jump through nearly all of the same hoops they need to jump through under current law.
Ayotte’s proposal fails this test. Even if she does offer free condoms.