Testimony on Contraception Access in the States
Chairwoman Miller-Meeks and members of the committee,
My name is Courtney Joslin. I lead research on pharmacy access to birth
control for the R Street Institute, 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,
including access to hormonal contraception in the states.
To date, 10 states and the District of Columbia have passed pharmacy access
models that allow pharmacists to prescribe hormonal contraception to patients.
These states are Oregon, Washington, California, Utah, Tennessee, Maryland, New
Mexico, New Hampshire, Hawaii and Colorado.
In these states, allowing pharmacists to prescribe birth control has
already proven beneficial in many ways. First, this expands pharmacists’ scope
of practice and permits them to provide medical services that they are already
well-equipped to perform. When a patient sees a doctor to get a birth control
prescription, she typically fills out a self-reported medical questionnaire, takes
a blood pressure test and talks with the doctor about which form of
contraception is right for her. Pharmacists can expertly perform all of these services.
Second, expanding the number of birth control providers gives more
women access to safe and effective contraception. This is a pressing need that
the state of Iowa has addressed in other ways, such as the Iowa Initiative, which
gave Iowans better access to long-acting methods like intrauterine devices
(IUDs). However, improved access to birth control is always benefitted by a
multi-pronged approach. It is well-known
that Iowa has historically experienced high rates of unintended pregnancies. 43
percent of pregnancies were unintended in 2010. This is partially because access
to doctors is limited, especially in rural areas. Passing a pharmacy access
model would contribute to the efforts of the Iowa Initiative by further
increasing the number of healthcare providers that can prescribe birth control.
Each unintended pregnancy strains mothers, families and the state’s
budget. In 2010 alone, taxpayers funded the medical costs of over 61 percent of
unintended pregnancies in Iowa, which totaled over $175 million – the state of
Iowa shouldered $48
million of these costs. When unintended pregnancies are reduced, these tax
dollars can go toward other family-oriented programs, or even education.
Pharmacy access models have grown in popularity in the states over the
last few years. What’s more, medical professionals have largely endorsed the
idea of providing easier access to birth control. In fact, the American College
of Obstetricians and Gynecologists has stated that birth
control should be available over the counter instead of prescribed. The
over-the-counter model is a federal issue, however, so states can get ahead of
the curve by allowing better access to birth control through the pharmacy access
The pharmacy access model provides all the aforementioned benefits. It
reduces unnecessary regulation, expands consumer choice, provides better
women’s healthcare access and has the potential to save millions of taxpayer
dollars. Most importantly, it does all of this without increasing any risks. It’s
easy to see that the pharmacy access model is a system in which everybody
Thank you for your time.
Courtney M. Joslin
Commercial Freedom Fellow
The R Street Institute