Here's the main problem I have with the concept over the counter birth control: It's not free and it doesn't enable people to get the best option for them based on medical advice.

I believe that all people who need birth control should have the right to access free birth control that is covered by their health insurance, regardless of their income or their proximity to a health-care practitioner or pharmacy.

This is exactly what the Affordable Care Act has done for millions of women. We should be working to expand access to free birth control - making it available over the counter is the perfect excuse for anti-choice politicians to make it harder to access.

Over-the-counter birth control is a devil's compromise conservative politicians want to hand women: While it would be theoretically easier to access a birth-control pill without a prescription, that's simply not the reality for low-income women or women in certain areas.

Meanwhile, if in theory women can afford the pill, politicians can then argue (erroneously) there's no need for the government to guarantee access to reproductive health care or fund family planning services or the Republicans' favorite enemy, Planned Parenthood. We might as well do away with the careful provisions in the ACA that mandate free access to birth control, because in theory any woman can get it at their local pharmacy.

Meanwhile, thanks to the freedom to discriminate based on religious ideology, pharmacies will be at liberty to refuse to stock or fill requests for over-the-counter birth control, leaving women with fewer and fewer options to access birth control. Insurance companies, looking to cut costs, will feel free to refuse to cover prescriptions for birth-control medication, even if the birth control that's available over the counter doesn't work properly for a patient.

The concept ignores the grim reality that not all people can just go to a pharmacy and easily purchase birth control. Some face religious and social backlash for buying pills in full view of their pharmacist and people from their community. Some can't afford to purchase the pill - if you're counting pennies and choosing between food and birth control, food wins. Some are young and under a certain state's law can't purchase birth control without a parent's consent. Some are transgender or gender-nonconforming. Some have medical conditions or allergies that place them at risk of serious side effects if the birth control they use isn't carefully selected and the dosage modified to fit their bodies. The list goes on.

The reality is that most, if not all, people who need or use birth control have to find a specific combination of hormones that works for their body. It may shock some of the male politicians who are governing our right to access birth control, but millions of women don't all just take one type of pill and have one giant mutual menstrual cycle. Each person's hormones and menses are different, and getting the hormone combination in our birth control just right is just as important as being able to access birth control in the first place.

Each person who wants or needs birth control should have the right to access expert medical advice to determine what works for them. Every medication has potential side effects - including over-the-counter ones. And no one short of a licensed professional has a good grasp on what dosage of birth control is right for a person.

Birth control should be available by prescription free of charge, based on the recommendations and individualized care that reproductive health-care specialists can provide.

What we need to work at is providing better, more affordable reproductive health-care access for all Americans, including free access to birth control.

Olivia Alperstein is the deputy director of communications and policy at Progressive Congress ( She wrote this for