Chairwoman and members of the committee,

My name is Courtney Joslin and I am a Commercial Freedom Fellow for the
R Street Institute, a nonprofit, nonpartisan public policy research
organization. Our mission is to engage in policy research in many areas,
including access to hormonal contraception. I lead R Street’s research on the pharmacy
access model, and I appreciate the opportunity to discuss birth control
paradigms and best practices regarding contraceptive access in the states.

Today, 10 states plus the District of Columbia allow pharmacists to
prescribe hormonal contraception to patients. These states are Oregon,
Washington, California, Utah, Tennessee, Maryland, New Mexico, New Hampshire,
Hawaii and Colorado.

Expanding pharmacists’ scope-of-practice to include prescribing birth
control permits them to perform medical services that they are well-equipped to
administer. A typical doctor’s visit to obtain birth control includes a
self-reported medical questionnaire, a blood pressure test and a quick chat
with the doctor about which types of contraceptives are right for the patient.
Pharmacists can expertly perform all of these activities.

Furthermore, expanding the number of birth control providers means more
women can access safe and effective contraception. In 2011, 45 percent of
pregnancies in the United States were unintended. This has negative outcomes,
both with respect to maternal health and public expenditures. For example, in
2010 alone, federal and state governments spent over $21 billion on the medical
costs associated with unintended pregnancies. Of that, state governments
shouldered nearly $6.4 billion.

In part, this is because many women—especially in rural areas—face
limited access to doctors. Put simply, increasing the number of healthcare
providers opens more doors for obtaining effective birth control. Given this,
allowing pharmacy access could significantly reduce the amount of tax dollars
spent on unintended pregnancy costs.

Over the past several years, the pharmacy access model has gained
traction in many states, and medical professionals have largely agreed with
making access to birth control easier. In fact, the American College of
Obstetricians and Gynecologists has stated that birth control should be
over-the-counter instead of prescribed. This is because it is safe and
effective, and women are capable of choosing the method that works best for
them without the unnecessary intermediation of a doctor.

Thank you for your time,

Courtney Joslin

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