Testimony from:
Courtney Joslin, Commercial Freedom Fellow, R Street Institute

Regarding SB 286, An Act to amend 450.095 (title) and 450.095 (3); and to create 450.01 (16) (L), 450.095 (1) (ag) and (ar) and 450.095 (2m) of the statutes; relating to: permitting pharmacists to prescribe certain contraceptives, extending the time
limit for emergency rule procedures, providing an exemption from emergency
rule procedures, granting rule-making authority, and providing a penalty.

November 20, 2019

Senate Committee on Health and Human Services

Chair Testin, Vice Chair Kooyenga, and members of the Senate Committee on Health and Human Services:

Thank you for considering my testimony today. My name is Courtney Joslin, and I am a Commercial Freedom Fellow for the R Street Institute. R Street is a nonprofit, nonpartisan public policy research organization. Our mission is to engage in policy research and outreach to promote free markets and limited, effective government in many areas. This includes working to reduce overly burdensome regulations that restrict both consumer freedom and professionals’ ability to work in their highest capacities. This is why SB 286 is of particular interest to us.

Birth control access is hampered by state regulations that only permit doctors and some advanced-practice clinicians to prescribe hormonal birth control. In Wisconsin, as well as the majority of states, women are still required to go through the process of a doctor’s visit just to maintain their birth control routine. A typical visit for a birth control prescription consists of a patient filling out her medical history, a blood pressure check and discussing which contraceptive methods she prefers. Only then is she given a prescription, which she can take to the pharmacy to have filled. But this restrictive barrier is unnecessary, as some states are proving with the “pharmacy access” model that SB 286 would allow.

In the last few years, both Republicans and Democrats in 11 states and Washington, D.C., have passed bills allowing pharmacists to undergo contraception-specific training and subsequently prescribe birth control directly to patients. This pharmacy access model is proving successful—and beneficial—for women, their families, taxpayers and the medical community.

First, leading medical organizations, such as the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians and the American Medical Association all advocate for lowering the barriers to birth control due to its time-tested track record of safety and effectiveness. The birth control pill gained FDA approval 60 years ago and since then has helped millions of women plan for their families and alleviate other reproductive health issues. In fact, the aforementioned medical organizations go so far as to advocate for complete over-the-counter access to birth control.

However, over-the-counter access is a federal issue, so states like Tennessee, Utah, West Virginia and New Hampshire have all reduced barriers to birth control by enacting pharmacy access laws that allow women to go directly to a pharmacist for their birth control prescription.

Pharmacists are experts in medication, and allowing them to prescribe birth control after undergoing additional training frees them to practice well within their abilities. Oregon, which was the first state to implement pharmacy access, has already seen positive results within just two years of implementation. In those two years, Oregon pharmacists wrote 10 percent of new birth control prescriptions for Medicaid patients, none of whom had been on a birth control method previously. Additionally, patients enjoy and are comfortable seeing a pharmacist for birth control. In a pilot study in Washington, virtually all patients who saw a pharmacist for birth control said they would continue to do so.

Finally, it is important to consider just how pharmacy access ultimately benefits women and Wisconsinites. Pharmacy access can be especially beneficial for those in rural areas, the uninsured, or those who simply cannot afford the time and expense of regularly seeing a doctor to maintain their prescription. Additionally, it helps women plan for their families and futures. As the Wisconsin chapter of the American Academy of Pediatrics has highlighted, 46 percent of pregnancies in Wisconsin were unintended in 2010. Unintended pregnancies impose costs on both individuals and taxpayers. For example, in Wisconsin that same year, taxpayers spent over $313 million on the medical costs associated with unintended pregnancies. Additionally, 40 percent of unintended pregnancies end in abortion each year, but better access to birth control in recent years has led to fewer unintended pregnancies and, in turn, fewer abortions. In fact, in Oregon, the pharmacy access model reduced unintended pregnancies and publicly funded medical costs in just two years after implementation.

Wisconsin should allow resident pharmacists to join the hundreds of pharmacists across the country who are successfully prescribing birth control to women. This is not only a safe and reasonable reform that the medical community supports—it directly lowers the costs imposed on both taxpayers and families due to unintended pregnancies. For all of these reasons, I urge the committee to pass SB 286.

My genuine thanks for your time,

Courtney Joslin
Commercial Freedom Fellow
R Street Institute
202-900-9736
cmjoslin@rstreet.org