Tricare Should Cover Newly Approved Over-the-Counter Birth Control Pill, Lawmakers Tell Pentagon

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pharmacy technician pulls medication from storage
Jessica Carbajal, 355th Healthcare Operations Squadron pharmacy technician, pulls medication from storage in the Exchange Pharmacy at Davis-Monthan Air Force Base, Ariz., May 23, 2023. (U.S. Air Force photo by Staff Sgt. Abbey Rieves)

A group of 34 lawmakers sent a letter Monday to the Pentagon and Defense Health Agency asking them to expand Tricare access to a new over-the-counter birth control pill for service members and their dependents.

The Food and Drug Administration approved Opill in July, making it the first daily oral contraceptive approved for use in the U.S. without a prescription. The letter obtained by Military.com was spearheaded by Sen. Michael Bennet, D-Colo., and was signed by 33 other senators, two of whom are Republicans. It was sent to the Department of Defense on Monday.

"Our service members and their families shouldn't have to jump through hoops to access essential reproductive health care," Bennet told Military.com in an exclusive statement. "That's why we're urging the Pentagon to expand access to over-the-counter birth control on military bases. The men and women of our military signed up to defend our rights, and we need to defend theirs."

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Coverage for Opill under the military health care system could give hundreds of thousands of women access to the contraceptive, which could be an easier alternative to traditional birth control pills that require a doctor's approval.

"The Military Health System serves approximately 1.6 million women of reproductive age, including service members, retirees, and their dependents," the lawmakers' letter reads. "As part of the full spectrum of reproductive health care, contraception provides individuals control over their reproductive health and family planning. Access to contraception, as well as education about it, increases readiness and improves quality of life for our service members and their families."

In their Monday letter, the senators asked the Department of Defense if it will provide Opill for a zero dollar copay, waive prescription requirements for the drug "both currently approved and those approved in the future," and work with the services "to stock OTC contraceptives in exchanges without unnecessary or burdensome restrictions."

The letter asks the Pentagon to respond to those questions no later than Oct. 31.

Democrats for years have pressed for easier access for birth control through the military health system. While civilians have had access to free birth control since Obamacare became law in 2010, dependents and military retirees who use Tricare are still subject to a copay for birth control pills. As with other prescriptions, active-duty service members can get prescription birth control free of charge.

Since July 2022, Tricare has waived copayments for reversible medical contraception such as IUDs, but it cannot legally waive copays for prescription pills. Legislative efforts to eliminate copays for dependents and retirees have repeatedly fallen short.

The House version of this year's defense policy bill would eliminate copays for contraception, but similar provisions have been taken out of defense bills before they were signed into law in previous years.

The push to expand military health care access to the new over-the-counter birth control pill also comes in the wake of the Supreme Court ruling last year to overturn Roe v. Wade -- known as Dobbs v. Jackson Women's Health Organization -- which eliminated the constitutional right to terminate a pregnancy and allowed numerous states to restrict or ban abortions.

The landmark decision was seen as a massive victory for anti-abortion advocates who had opposed Roe. But defense officials have argued it could deter women from joining or staying in the military if they have to be stationed in states that have banned abortion.

The Pentagon reacted to the high court's decision by taking steps to increase access to birth control. Specifically, the department expanded walk-in contraceptive services at military health care facilities. In addition to making it easier to get contraception, the Pentagon began offering leave and travel cost reimbursements to troops who seek out civilian abortion and reproductive health services.

Republicans have fought to reverse the military's new reproductive health care policy. The fight over abortion access for troops has stalled hundreds of normally routine military promotions. Sen. Tommy Tuberville, R-Ala., has for months objected to and effectively stalled the speedy Senate approval of the promotions while demanding that the Pentagon reverse its abortion policy.

The two Republicans who signed the letter sent Monday, Sens. Susan Collins of Maine and Lisa Murkowski of Alaska, frequently break with their party on issues of reproductive rights.

The letter was also signed by several Democrats in tough reelection battles, including Sens. Jon Tester of Montana, Sherrod Brown of Ohio and Jacky Rosen of Nevada. As with the 2022 midterm elections, Democrats are hoping voters' concerns about reproductive health care give them an edge in 2024.

-- Thomas Novelly can be reached at thomas.novelly@military.com. Follow him on Twitter @TomNovelly.

-- Rebecca Kheel can be reached at rebecca.kheel@military.com. Follow her on X @reporterkheel.

Related: Lawmakers Want the Pentagon to Waive Tricare Copays on Birth Control Services

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