Nurx is a small telemedicine app that makes access to birth control and the morning after pill a little more convenient. The app, which has expanded to 13 states and Washington, DC, is simple: for $15 a month, you enter your health and insurance information, choose your birth control preference, and have it delivered to your home. The information is reviewed by a doctor in your state who signs off on the prescription. In theory, Nurx shouldn’t be controversial since all it fundamentally does is eliminate a visit to a gynecologist’s office. The app also provides access to two brands of the morning after pill, Plan B and Ella. As Nurx expands into more states, the accessibility to the morning after pill has anti-abortion groups concerned.
Nurx, it seems, has waded into an old fight that long preceded the app: Namely over whether or not Plan B and Ella are abortifacients and how much government intervention should take place before a woman obtains the morning after pill. Stat News reports:
The Food and Drug Administration has approved a popular brand, Plan B, for over-the-counter sale in all states for women who pay out of pocket. But if a woman is using her insurance benefits to cover the drug, she’ll typically need a prescription for Plan B. And a newer emergency contraceptive, Ella, is only available with a prescription. The app, then, short-circuits this divide and lets insured women easily get the morning-after pill in a way more akin to the over-the-counter interaction.
By eliminating the step for women using their insurance, the app is essentially working against legislative roadblocks to the morning after pill being constructed in conservative states. Stat notes that nine states have restrictions on emergency contraception, making the morning after pill harder and harder to obtain (particularly if women want to use insurance rather than pay out of pocket).
Those laws have largely been passed in response to anti-abortion advocates who argue that the morning after pill is an abortifacient. This isn’t a particularly new argument—Hobby Lobby used it during their Supreme Court case—but it reflects an increasing commitment from anti-choice groups that life begins at fertilization rather than the implantation of a fertilized egg into the uterine wall. But that stance is out of sync with the realities of women’s bodies. Again via Stat:
[...] according to Susan Wood, an associate professor of health policy at George Washington University. They assume that “a fertilized egg is the same as pregnancy and is the same as a person,” Wood said. She says that’s simply not the case because about half of fertilized eggs never implant in the uterus. “A woman is not pregnant until the egg is implanted and stabilized,” Wood said.
Regardless, Nurx, as well as state telemedicine laws, seem to be on the legislative agenda for a number of anti-abortion groups. In North Carolina, for example, activists asked lawmakers to review the app as part of the state’s review of its telemedicine laws. It’s likely that as Nurx expands, it will face legislative hurdles or immense pressure to stop providing the morning after pill.
