As the U.S. Supreme Court debates legislation that makes access to abortion more difficult, advocates and lawmakers are pushing forward on another aspect of reproductive rights: birth control.
California and Oregon each passed laws over the past couple of years that let pharmacists dispense birth control without a prescription. In Oregon and Washington, D.C., new laws require insurers to pay for 12 months' worth of contraceptives at a time.
Similar legislation is being introduced elsewhere, including a few states that are generally more conservative and skeptical about reproductive rights. So far, a total of 11 states -- Alaska, Hawaii, Iowa, Illinois, Massachusetts, Missouri, New Jersey, New York, South Carolina, Tennessee, Washington and Wisconsin -- have seen bills introduced this year that would allow pharmacists to dispense birth control. Three states -- Hawaii, Washington and Wisconsin -- are considering 12-months-supply legislation.
“I believe that if a bill like that could make it to the floor of a more red-leaning state, it would pass,” said Mary Nolan, executive director of Planned Parenthood Advocates of Oregon. “Once people realize that birth control is just a basic part of women’s health care, they will allow for opportunities to make it more accessible.”
Birth control has been a tough sell in red states in recent years. Federal law requires insurance plans to pay for some form of contraceptives, but 20 states offer exemptions from the mandate for some employers and insurers.
In Tennessee, one of the more conservative states, advocates hope the new contraceptives bill will start a conversation about reproductive freedom with those who aren’t comfortable with abortion.
“We have seen a lot of anti-abortion rhetoric and legislation in recent years," said Allison Glass, state director of Healthy and Free Tennessee, a coalition focused on sexual and reproductive freedom. "If we need to focus on contraceptive access in order to give women choice throughout their reproductive life, then that’s what we will do."
While this type of legislation hasn't created an immediate outcry from conservative groups, it also isn't being embraced with open arms. Some state affiliates of the Family Research Council didn't have a comment on the pending legislation in their states, while others expressed concerns.
"I just feel that it's something that should stay between the physician and the patient," said Julaine Appling, president of Wisconsin Family Council. "We're not talking about an aspirin, we're talking about a potent medicine with side effects."
In Tennessee, the Family Action Council is worried that the bill would lead to abortion-inducing pills also being dispensed without a doctor's prescription. The group also objects to the lack of a minimum age requirement.
California has no age restriction, but Oregon pharmacists require a girl younger than 18 to get her first birth control prescription from a doctor. In both those states, women have to fill out a health questionnaire and have a short consultation, in which pharmacists will encourage them to see a doctor for further medical advice.
California’s law is set to go into effect April 1, once standards by the California Pharmacy Board are finalized. From there, it's up to pharmacies to decide if they want to participate. As is the case in Oregon, California will likely only require pharmacists to complete a training if they’ve been out of school for a certain amount of time. Several hundred pharmacists in Oregon have already completed the hours-long online training this year, according to Nolan.
Glass, the Healthy and Free Tennessee director, isn’t particularly optimistic that her state will pass its birth control measure this year. But she's encouraged it's being debated nonetheless.
"Whether or not it passes, it’s more about a longer term strategy to improve access to care," she says. "If we really want to decrease the number of unintended pregnancies, then we could start with contraceptive access. But the fact is, it takes a lot of courage [to make] this sort of culture change work in Tennessee."