Democrats Call For Full Opill Insurance Coverage

Democrat lawmakers are calling on the Biden administration to ensure private health insurance plans will fully cover the first over-the-counter birth control pill in the United States, CNN reported.

Several dozen Senate Democrats have urged federal agencies to require private insurance plans to cover Opill without cost-sharing. The first birth control pill without a prescription is expected to appear on store shelves early next year.

The letter, sent Monday morning and obtained by CNN, was addressed to Health and Human Services Secretary Xavier Becerra, Treasury Secretary Janet Yellen, and Labor Secretary Julie Su.

"The FDA’s approval of Opill is a milestone; however, for an OTC birth control pill to meet its potential and be truly accessible, federal departments must ensure that it is covered without cost-sharing and without the need for a prescription as a condition of coverage," the letter reads.

The U.S. Food and Drug Administration (FDA) greenlighted Opill in July, making it the first daily oral contraceptive approved for use in the U.S. without a prescription. The progestin-only pill is expected to be available at drug stores, convenience stores, and grocery stores, as well as online.

In their letter, the lawmakers urged the federal agencies to issue new guidance that reflects the current Health Resources and Services Administration (HRSA) guidelines and clarifies that "federally and state-regulated private health plans must cover OTC contraceptive products without cost-sharing, including when purchased without a prescription."

According to the Affordable Care Act, health insurance plans must cover at least one FDA-approved prescription contraceptive as part of their benefits. However, for that coverage, health plans typically require a prescription.

Earlier this year, President Joe Biden issued an executive order directing the departments to consider new ways to improve contraception access and affordability, including better access to OTC medications without cost-sharing.

Six states have passed laws requiring state-regulated health plans to fully cover certain OTC contraception without a prescription. In comparison, seven states use state-only funds to provide this coverage for Medicaid enrollees, according to a recent report from the Kaiser Family Foundation (KFF).

How effective is Opill?

Opill, manufactured by Perrigo Company, is 98% effective at preventing pregnancies if taken as directed, which is at the same time every day.

The most common side effects of the drug include irregular bleeding, headaches, dizziness, nausea, increased appetite, abdominal pain, cramps, or bloating.

The FDA warns that Opill should not be used by those who have or have ever had breast cancer, nor in combination with another hormonal birth control product, such as an oral contraceptive pill or contraceptive patch.

Two in five American females of reproductive age would be likely to use OTC birth control pills if the FDA approved them, a 2022 poll by the KFF reveals.

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