Bobby Jindal’s Smart Play on Contraceptives

Today brings some evidence that Bobby Jindal is a smart guy. In the Wall Street Journal, he writes that contraceptives should be available over the counter:

Let’s ask the question: Why do women have to go see a doctor before they buy birth control? There are two answers. First, because big government says they should, even though requiring a doctor visit to get a drug that research shows is safe helps drive up health-care costs. Second, because big pharmaceutical companies benefit from it. They know that prices would be driven down if the companies had to compete in the marketplace once their contraceptives were sold over the counter.

Jindal knows his audience. All he’s saying here is that prescriptions are required by the FDA, but if you’re talking to conservatives it’s better to refer to this as “big government.” And I guess a bit of Big Pharma bashing does no harm even in the pages of the Journal.

But however you phrase it, Jindal is basically right. There’s plenty of evidence that oral contraceptives are safe enough to be sold over-the-counter. But why associate himself with this quixotic notion? What’s in it for Jindal?

As a conservative Republican, I believe that we have been stupid to let the Democrats demagogue the contraceptives issue and pretend, during debates about health-care insurance, that Republicans are somehow against birth control. It’s a disingenuous political argument they make.

….Contraception is a personal matter—the government shouldn’t be in the business of banning it or requiring a woman’s employer to keep tabs on her use of it. If an insurance company or those purchasing insurance want to cover birth control, they should be free to do so. If a consumer wants to buy birth control on her own, she should be free to do so.

Jindal understands that, like it or not, Democrats were quite successful at demagoguing Republicans this year over their opposition to the contraception mandate. And yet, the Republican base is still dead set against the idea that “religious institutions” should be required to pay for contraceptives for their employees. How to square this circle?

Easy: if contraceptives are sold over the counter, then the issue disappears. Insurance doesn’t usually cover non-prescription drugs, which means the mandate goes away. No employer-provided insurance plan will have to cover contraceptives, so the whole fight over religious objections evaporates.

What’s more, smart liberals would probably support this idea too, for several reasons. First, the evidence suggests that oral contraceptives are safe enough to be sold OTC. So it’s good public policy in general. Second, the cost of contraceptives would almost certainly drop substantially if this happened. They’re cheap to manufacture, after all. Third, all things considered, OTC availability would probably make contraceptives more available and more widely used than prescription contraceptives subsidized by insurance companies.

This is why I said Jindal is smart. He’s picked an issue that has good scientific backing, offers a strong chance of bipartisan support, and eliminates an emotional fight that conservatives are losing. It also gives him some street cred as a guy who wants to turn down the temperature on the culture wars. Not bad.


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