Why legalizing over-the-counter birth control is good politics

14 May 2023

I am not saying that a panel of federal health advisers at the US Food and Drug Administration acted politically when it said Wednesday that a decades-old birth control pill should be sold over the counter.

I am saying it looks that way.

Thank God for that.

The Associated Press reported that a “panel of FDA advisers voted unanimously in favor of drugmaker Perrigo’s request to sell its once-a-day medication on store shelves alongside eye drops and allergy pills.

“The recommendation came at the close of a two-day meeting focused on whether women could safely and effectively take the pill without professional supervision. A final FDA decision is expected this summer.”

The decision was a long time coming. The drug, called Opill, contains progestin. Opill was first approved 50 years ago. It has been shown to be more than 90 percent effective when taken daily. Its approval wouldn’t apply to other pills, but other drug makers are expected to seek approval. Birth control pills are widely available in most of the rest of the world.

Like I said, I’m not saying the FDA panel acted politically. It seems to have based its recommendation on fact and science. Still, choices were made.

There was concern, for instance, about whether consumers would understand how to take it on their own. But the panel decided the benefits of broad availability outweighed concern about reading comprehension. It also said that young people and lower-income groups would benefit most.

That looks political.

Again, thank God for that.

We tell ourselves to worry about trusted institutions like the Food and Drug Administration doing things for “political reasons.” We believe they should act non-politically. But as I have often argued, human organization and development never occur in a vacuum. Politics is always already with us.

The question should not be whether politics is or isn’t with us. It should be whether it’s good or bad. In a democratic republic like ours, the question should be whether that politics is in the interest of the common good.

If the FDA skips over facts and science to fast-track a drug so that a giant pharmaceutical firm can turn a profit faster (it is periodically accused of such things), that’s not in the common good’s interest. That’s bad politics. But when it greenlights, for over-the-counter use, a drug that’s known to be widely effective, it is in the common good’s interest. That’s good politics.

And greenlighting such a drug is especially good politics at a time in our history when the bodies of women are becoming subject to increasing regulation by state governments dominated by illiberal Republicans.

The fall of Roe was the catalyst. But abortion isn’t the only thing affected. As long as Roe stood, so stood the right to privacy. Now, state governments run by illiberals are experimenting with ways to regulate all private affairs. That includes not just abortion but the entire gamut of reproductive rights.

Meaning, birth control – condoms, IUDs, the pill, etc.

The illiberals already believe abortion is a form of birth control (it isn’t). We can’t expect them to honor the difference now that the Supreme Court has given them the authority to regulate women’s bodies. So far, only the most extreme among them are talking about banning birth control. In time, however, we can expect that thinking to drift toward the GOP’s center.

In this sense, Wednesday’s recommendation by the FDA panel is prescient. It anticipates a pattern – a tightening of regulatory circles around the bodies of women at the state level and a loosening of the same at the federal level.

The Biden administration has already said that it’s legal to deliver mifepristone (the so-called abortion pill) through the US mail, even into illiberal states with severe restrictions on abortion. The administration is also fighting an effort in federal courts to reverse its approval by the FDA.

Now, with this new recommendation by the FDA’s panel of health advisers, the Biden administration is broadening access to birth control pills. It is therefore creating political conditions in which abortion services might not be needed, especially for young people and lower-income groups.

That’s good politics.

Thank God for that.

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