Only certain documents are accepted: photo documents issued by a US state and certain federal documents. There are some exceptions in the initial act text, but in practice, nobody is going to accept your nursery school record.
There are certainly 10s of millions of people who don't have direct access to this drug.
You honestly think there are 10s of millions of people wanting a decongestant in the United States without ID? This is ridiculous and I agree with the other commenter, a bit hyperbolic.
And if they require a drivers license but their system is based on an electronic reader and that reader is broken, then you are out of luck. No sudafed for you.