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Editor's note: Jill Filipovic is a journalist based in New York and author of the book “OK Boomer, Let’s Talk: How My Generation Got Left Behind.” Follow her on Twitter. The opinions expressed in this commentary are solely her own. View more opinion on CNN.

(CNN) — A year and a half after Republican-appointed Supreme Court justices overturned Roe v. Wade and stripped the constitutional right to abortion from American women, the Republican Party has been floundering.

It turns out that the American public is broadly pro-choice, according to a CNN poll from August, and many voters are horrified by the predictable results of abortion bans: child rape victims unable to end dangerous pregnancies in their home states, women nearly dying of treatable pregnancy complications, mothers with much-wanted but tragically doomed pregnancies being denied the ability to choose how those pregnancies end.

And, of course, women who are simply forced to remain pregnant when they don’t want to be or can’t afford to be. Some Republican politicians, and some conservative activists, argue that the party needs to show it’s actually “pro-life,” as it calls itself, and not just anti-woman by embracing a slew of policies that would help women prevent unwanted pregnancies, and help them to carry pregnancies safely to term and raise children in more stable environments.

None of this, of course, has come to pass. Republicans have not made the US a safer or better place for pregnant women or mothers since they banned abortion or scaled access to the procedure back in nearly every red state. Nor have they made contraception easier to access.

But now they have a chance. Democrats are pushing for full insurance coverage of over-the-counter birth control pills, a move that would make a reliable pregnancy prevention tool much more accessible — especially for the financially struggling women who are the most likely to experience unexpected pregnancies.

So where are the Republicans?

Back in July, the US Food and Drug Administration (FDA) approved an over-the-counter birth control pill, called Opill. Health advocates emphasize that this pill could be a gamechanger for American women, who for long have had one of the highest rates of unintended pregnancy among developed countries.

Solving this problem is fairly simple: Give women easily accessible and very reliable tools for preventing pregnancy, and women have far fewer unintended pregnancies — and by extension, fewer abortions and fewer unplanned births.

Conservative advocacy groups and the anti-abortion Republican Party, though, have largely opposed this strategy. While a few conservatives have written op-eds in favor of contraception being legal, they also routinely position it as a matter of “individual responsibility”: in other words, that if women want to have sex without risking pregnancy, they should have to (literally) pay for it.

The GOP generally does not support efforts to make birth control free. And most major anti-abortion organizations either oppose the most reliable forms of contraception or take no position.

The problem with that, though, is that women living in poverty or at its edge, or women who are young or uninsured, can have a tough time getting their hands on reliable contraception. A doctor’s appointment can be a significant barrier to women who are struggling to manage low-wage work and the demands of children: It means time off of work, lost wages, paying for childcare, money for gas or bus fare, then getting to the pharmacy to fill a prescription — and then doing it all again whenever the script runs out.

Over-the-counter birth control removes a big barrier — the doctor — but it doesn’t solve for cost. As it stands, the Affordable Care Act (ACA)’s contraception mandate generally makes contraceptives free — an effort that conservatives fought tooth and nail, and even took to the Supreme Court in 2014, arguing that religious “pro-life” businesses owners shouldn’t have to provide insurance plans that cover contraceptives they object to (they won).

But over-the-counter drugs are often not covered by insurance, and the contraception mandate doesn’t cover over-the-counter contraceptives, even though these more-accessible pills may soon become the most popular contraceptive pill option.

Democrats are trying to change that by extending the ACA’s contraception mandate to over-the-counter pills. Democratic Sen. Patty Murray of Washington has 35 cosponsors for a Senate bill that would require insurance to cover any contraceptive approved by the FDA for over-the-counter use, with or without a prescription. The bill doesn’t have a single Republican cosponsor.

That’s awfully telling: The same party that claims it wants to end abortion refuses to support one of the most effective ways to decrease the abortion rate.

At the same time, American women are seeing a health care crisis, especially in conservative “pro-life” states. Republican abortion bans have made these states extremely hostile to health workers, especially those specializing in women’s health, OB/GYN, and obstetrics.

Doctors in anti-abortion states now face serious civil and criminal penalties if they make treatment decisions that conservative legislators have outlawed — including treatments that are standard in places where abortion is legal, such as miscarriage management, procedures to end life — and health-threatening pregnancies, and treatments for ectopic pregnancies. And doctors are people, many of them of reproductive age, or parents of children who will eventually be of reproductive age. Who can blame them for refusing to put their lives, livelihoods and freedom at risk by living and practicing medicine in states with laws that ban abortion, threaten doctors and risk women’s lives in the name of “pro-life” politics?

As a result of abortion bans, some doctors are fleeing conservative states and health clinics are shutting their doors. Many of these states were already struggling with health care shortages and major health care challenges. Now, women have fewer options for care: nowhere to get a safe abortion, and fewer and fewer options for gynecological care, emergency care and childbirth.

Women and children in conservative “pro-life” states are also worse off by a variety of measures. Children in these states are more likely to live in poverty. Women are more likely to die in pregnancy, childbirth or soon after. Women and their children are less healthy. These are the conditions that anti-abortion Republican politicians have failed to correct, or even helped to create.

So, it is perhaps no surprise that Republicans are also refusing to make it easier for women to prevent unintended pregnancies, at the same time as they are making it harder for women to end unintended pregnancies. But it is shameful. It should be scandalous. And it serves as further proof that the right-wing opposition to abortion is not about saving lives or protecting women. It’s all about making women’s lives smaller and making all of us less free.

The-CNN-Wire
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