For over six decades, women in America have depended on oral contraceptive pills as a method to avoid pregnancy and manage other health conditions. In July 2023, the U.S. Food and Drug Administration (FDA) gave the green light for the first over-the-counter daily oral contraceptive pill, which is anticipated to hit the market in early 2024. This brief offers a detailed look at oral contraception, touching on insurance coverage through private plans and Medicaid, and explores strategies to enhance and broaden women’s access to these contraceptives.
Oral contraceptive pills, commonly known as OCPs, contain hormones like progestin and estrogen and are consumed orally each day to prevent pregnancy. There are three main types: the combination pill, the progestin-only pill, and the continuous use pill. These pills are highly effective when used correctly, with a failure rate of less than 1%. However, the failure rate jumps to 9% with “typical use,” which includes inconsistent or incorrect usage.
OCPs are primarily used for preventing pregnancies but also serve other health-related purposes, such as managing menstrual-related disorders. Insurance coverage for OCPs has evolved over the years, with the Affordable Care Act (ACA) requiring most private plans to cover a wide range of preventive services, including all FDA-approved contraceptive methods for women, without patient cost-sharing.
Public programs like Medicaid also provide coverage for family planning services, including contraceptives. However, the scope of coverage varies between states. Efforts are underway to expand access to OCPs through various mechanisms, including making them available over the counter, allowing pharmacists to prescribe them, and using mail-based online services or smartphone applications.
The FDA’s recent approval of the first over-the-counter daily oral contraceptive pill, Opill, marks a significant milestone. This pill is expected to be available without age restrictions in stores and online in early 2024. Research indicates that over-the-counter access could increase the use of contraception and make it easier for women to continue using it. It could particularly benefit populations that have historically faced barriers to accessing contraceptive care.