Women in Hawaii may soon be able to obtain birth control pills and other forms of hormonal contraceptives directly from a pharmacist, cutting out the need to make a doctor’s appointment to obtain a prescription and increasing access to birth control for women with limited access to health care providers.
Under Senate Bill 513, pharmacists would be allowed to prescribe contraception provided that they complete an accredited educational course and require women seeking the pills to complete a quick risk-assessment survey.
The bill, a priority this year of the Women’s Legislative Caucus, passed the full Senate 24 to 1 and is slated for decision-making today by the House Consumer Protection and Commerce Committee, the last committee it needs to clear before it can be heard by the full House.
If the bill passes, Hawaii would join a growing number of states, including Oregon, California, Washington and New Jersey, that have recently passed laws allowing pharmacists to prescribe contraception.
“For the Women’s Caucus, it is about making sure that women have access to contraceptive services to prevent unintended, unwanted pregnancies,” Sen. Roz Baker, who introduced the bill, said via email. “Access means removing as many barriers as possible.”
About 56 percent of pregnancies in Hawaii in 2010 were unintended, according to the Guttmacher Institute, one of the highest rates in the country. That year, the federal and state governments spent $114.5 million on unintended pregnancies in Hawaii, primarily in Medicaid costs related to prenatal care and childbirth.
Supporters of SB 513 hope that by increasing access to prescription birth control via pharmacies, it will cut down on the unplanned pregnancy rate.
The measure has attracted support from Hawaii pharmacists, but reactions from health care providers have been mixed.
The American Congress of Obstetricians and Gynecologists says the bill doesn’t go far enough in opening up women’s access to contraception. The association backs over-the-counter access to birth control pills, cutting out the need to see either a doctor or pharmacist, and is opposing SB 513 and any other legislative proposals “that take only intermediate steps toward such access,” ACOG wrote in testimony on the measure.
The Hawaii chapter of ACOG represents more than 200 obstetricians and gynecologists in the state.
The association says that women are able to self-screen for contraindications of birth control pills, the most widely used short-term birth control method, and raised concerns that pharmacists could refuse to provide the contraception, creating an additional barrier for women.
Conversely, Planned Parenthood Votes Northwest and Hawaii, the lobbying arm for Planned Parenthood, has argued that pharmacists may not have the time or incentive to provide women with contraceptive counseling, even though the University of Hawaii’s College of Pharmacy, Hawaii’s Board of Pharmacy, and drugstore chains, including Walgreens, have supported the bill.
Planned Parenthood also argues that allowing women to pick up hormonal contraceptives from pharmacies could deprive them of information about the “full range of birth control methods,” information about sexually transmitted infections and routine health screenings.
It “seems this bill may not be ready for action, as many changes are needed to ensure that it meaningfully increases access to the full range of contraceptive methods,” Planned Parenthood wrote in testimony on the bill.
Representatives for Planned Parenthood didn’t respond to questions about what changes they would like to see in the bill, or whether they were concerned that a bill like SB 513 could impact their revenue because of a loss of patient appointments.
In an email, Planned Parenthood did say that it hopes the state would focus its efforts on programs that are “tried and proven,” like its Planned Parenthood Care App, which provides patients with online visits with health care providers who can prescribe birth control and discuss other health care issues.
“When patients don’t have time to wait for hours, days or weeks to see another provider, our Planned Parenthood Care App will help them to get the care they need,” Laurie Temple-Field, a lobbyist for Planned Parenthood in Hawaii, said in an email.
It can take more than two weeks to get an appointment at Planned Parenthood’s Honolulu clinic to obtain a new prescription for birth control pills, according to the clinic’s online scheduling system.
Critics, however, have argued that common methods of contraception shouldn’t be essentially held hostage so that women will come in for routine health screenings, such as Pap smears and STD testing.
“The provision of other preventive health services, such as cervical cancer screening and sexually transmitted infection testing, is not medically required to initiate or continue hormonal contraception,” ACOG noted in its testimony.
Rep. Roy Takumi (D, Pearl City-Waipio-Pearl Harbor), who recently took over as chairman of the House Consumer Protection and Commerce Committee, said he hadn’t yet made up his mind on whether he would recommend passing the bill today, or killing it for the session.
“Whether or not this bill is quite ready for prime time, I’m not sure,” he said, reiterating many of the arguments presented by Planned Parenthood.
A similar bill died last year in the Legislature.