Political pill
Published September 16, 2014
Editorial by Greensboro News-Record, September 16, 2014.
Thom Tillis surprised many viewers during the first U.S. Senate debate when he endorsed over-the-counter sales of oral contraceptives, but he wasn’t ad-libbing. He was following the same script as other Republican candidates across the country.
Dan Debicella in Connecticut, Cory Gardner in Colorado, Ed Gillespie in Virginia, Mike McFadden in Minnesota and others just in the last few weeks have adopted the same position. They’re using the tactic to deflect Democratic criticisms of their support for the Supreme Court’s Hobby Lobby decision.
That ruling wasn’t about contraception, Tillis said, but religious freedom. Hobby Lobby sued to be excused from requirements under the Affordable Care Act that it must pay for contraceptive coverage in employee medical plans because of religious objections. The court agreed.
Democratic Sen. Kay Hagan charges that Tillis opposes access to contraceptives. No, he doesn’t, he said. In fact, he proposed making oral contraceptives available over the counter to improve access and cut costs.
Is he sincere? He never made such a suggestion during the Republican primary campaign when all the candidates expressed opposition to abortion and offered the opinion that states have the authority to ban contraceptives. Tillis didn’t endorse a ban, but why even address such a possibility?
Under Tillis’ leadership as speaker, the N.C. House passed new abortion restrictions in 2011. In the debate, he didn’t specify what sort of oral contraceptives he meant. The so-called morning-after pill is sometimes considered an abortifacient because it can prevent the implantation of a fertilized egg in the uterus.
The American Congress of Obstetricians and Gynecologists supports over-the-counter access to birth-control pills but recommends that women consult their physicians about their reproductive health plans. And, because even over-the-counter options may be too expensive for some women, it “strongly supports” the coverage mandate under the Affordable Care Act.
Tillis’ new position only touches on the easy part of the discussion. It’s irresponsible to call for making oral contraceptives easier to obtain and leave it at that. He doesn’t address what kind of contraceptives, their cost and how to pay for them, or what role physicians should have in helping to determine what’s best for each woman. A comprehensive approach is needed to make sure that women’s reproductive health is fully addressed.
Ultimately, the Food and Drug Administration determines what medications require a prescription and which ones don’t. Some employers might prefer that many more pharmaceuticals were made available over the counter, especially those that are most expensive, so they wouldn’t have to pay for insurance coverage. But such decisions should be made for medical reasons.
Tillis and Hagan hold different views about access to abortion — he opposes it in most cases, she supports it in most cases — and about contraceptives. On the latter issue, it was a surprise to hear he has joined other Republicans in taking the more liberal position — if only superficially.
