Illinois has teed up another chance to become a proverbial laboratory of democracy by providing solutions to problems that the federal government has failed to solve. One such problem is limited access to birth control. To address this matter, Illinois State Rep. Michelle Mussman, D-Schaumburg, has introduced House Bill 1442, which would make Illinois the 11th state to find a way around the federal regulatory bottleneck and allow pharmacists to prescribe hormonal birth control. Rep. Mussman’s bill will receive a legislative committee hearing in Springfield this week.
To obtain birth control, women in Illinois must first make an appointment with their physician. These doctor’s visits involve only a self-reported medical questionnaire, a blood pressure test and a check on any special sensitivities of the patient. Yet pharmacists are trained to handle these sorts of procedures, and there are many reasons why Illinois should consider allowing them to do so.
To begin, the Guttmacher Institute estimates that nearly half of all pregnancies in the United States are unintended and as many as 41 percent of all Illinois pregnancies are unwanted or at least unplanned. These unintended pregnancies come with a huge public cost. Research indicates that the cost of unintended or unwanted pregnancies to taxpayers is over $21 billion annually. In Illinois alone, taxpayers shouldered over $352 million annually in health care costs associated with these pregnancies.
More importantly, according to the National Institutes of Health, there are several negative health trends linked to unintended pregnancies. For instance, these expectant mothers are more likely to be victims of domestic violence, to be clinically depressed and to use alcohol and tobacco products while pregnant than women who have planned their pregnancies. They are also less likely to receive proper prenatal care.
Additionally, many women in rural areas have greater access to pharmacists than to doctors — especially specialists like obstetricians. Even in large metro areas where doctors are plentiful, many women still lack health insurance. These factors make it more difficult for women to obtain hormonal contraceptives. Research indicates that many of these women would use oral contraceptives if they had easier access.
The most effective remedy for this situation would be to provide for over-the-counter access to birth control. This model would eliminate the need to go state-by-state to alter scope-of-practice rules. Unfortunately, doing so would require federal action, which has thus far been elusive. Yet there is a strong case for allowing over-the-counter access — even the American Congress of Obstetricians and Gynecologists supports the model, noting that decades of experience have demonstrated that hormonal contraceptives are safe for most women and that women are generally very successful at self-screening.
Meanwhile, 10 states and the District of Columbia have already enacted laws permitting women to bypass doctors and obtain hormonal contraceptives directly from pharmacists. Based on their experience, the pharmacy access model has been a useful tool for combating several public health problems. Put simply, Illinois has little to risk and everything to gain by adopting the pharmacy access model.