Bipartisan Bill Allows Pharmacists To Prescribe Birth Control

Birth control pills. Photo by Taylor Chase/Wisconsin Center for Investigative Journalism.

Patients over the age of 18 would be able to get a birth control prescription from a pharmacist rather than a primary care physician, under a bill considered by Wisconsin Assembly lawmakers on Tuesday.

Rep. Joel Kitchens (R-Sturgeon Bay), the lead Assembly bill author, told the Assembly Health, Aging and Long-Term Care committee that he decided to reintroduce the bill because of continued barriers to accessing birth control and the high costs associated with unplanned pregnancies.

“We’re proposing AB 176 to give women more choices in reproductive health care, decrease the number of unplanned pregnancies and abortions in our state, save taxpayer dollars and reduce generational poverty.” Kitchens said.

The bill was initially announced alongside Republican bill that would update Wisconsin’s 1849 abortion ban to include rape and incest exceptions during the first trimester and clarify the “life of the mother” exception already included in the law.

Currently in Wisconsin, patients seeking birth control must make an appointment with a doctor or advanced practice nurse, answer a mandatory list of questions regarding their health and then if it is safe for them to take hormonal birth control, they are given that prescription to take to a pharmacy to be filled.

The process can slow down patients’ ability to access birth control, especially as access to primary care physicians is limited, according to supporters of the bill. A 2020 report by the Legislative Reference Bureau said nearly 150 areas were facing shortages of primary care physicians with many of the areas located in rural parts of the state.

“As a pharmacist who works in a rural primary care clinic, I’ve seen how challenging it can be for patients to get in for an appointment with their primary care provider,” Marina Maes, a professor at the University of Wisconsin-Madison School of Pharmacy said. “The provider schedules are booked two to three months out, which limits patients’ access to timely and convenient care from trusted health care professionals.”

AB 176 would allow Wisconsin pharmacists to prescribe and dispense oral and patch birth control. Participation by physicians would be voluntary, and under the bill, the Pharmacy Examining Board would be directed to create rules establishing the standard procedures for prescribing contraceptives by pharmacy.

The bill includes a few requirements for the rules including requiring patients to fill out a self-assessment questionnaire and undergoing a blood pressure screening. The pharmacist would also need to make a report to a patient’s primary health care practitioner following the prescription. The bill would require dispensing birth control as soon as practicable after the issuing of the prescription.

Kitchens also indicated that the bill isn’t an extraordinary measure.

“I will point out that women can currently purchase birth control online after answering a few questions by telephone from a doctor. That process is far less rigorous than what’s prescribed in this bill,” Kitchens told the committee.

The bill was considered by the Legislature during the 2019 and 2021 sessions, but failed to pass the Senate each time.

“We were only about one vote short of getting it to the floor last time and I believe there’s a very good chance we will get it done this time,” said Rep. Clint Moses (R-Menomonie), chair of the committee. “I don’t want to keep doing this either.”

The bill has bipartisan support including four Democrat co-authors: Rep. Ryan Clancy (D-Milwaukee), Rep. Lisa Subeck (D-Madison), Rep. Christine Sinicki (D-Milwaukee) and Rep. Darrin Madison (D-Madison).

The bill has a long way to go, with several anti-abortion groups continuing to lobby against it, and it has yet to be considered by the Senate.

Wisconsin’s major anti-abortion organizations — Pro-Life Wisconsin, Wisconsin Family Action and Wisconsin Catholic Conference — are registered against the bill. The Wisconsin Catholic Medical Guild is the only medical group that registered against the bill.

Matt Sande, legislative director for Pro-Life Wisconsin, testified to the committee that hormonal methods of birth control are “abortifacients” and said the group doesn’t want the government doing anything that promotes access. He also said birth control is ineffective and therefore should not be supported by the state.

Kitchens spent an extended period of time during his testimony addressing misinformation cited by opponents including Sande.

“The primary cause of irregular use is lack of access,” Kitchens said. “I think it’s ironic that the people who oppose increased access to birth control are citing ineffectiveness when that lack of access is the major contributor to failure.”

According to Cleveland Clinic, hormonal contraceptives have the potential to be 99% effective if used correctly, however, most people don’t use them correctly, so the effectiveness is instead around 91%.

Sande also asked lawmakers why they were considering a piece of legislation that would promote less births when Wisconsin is going through a workforce shortage.

Rep. Lisa Subeck (D-Madison), a co-author, criticized Sande’s comments.

“I find it incredibly offensive that you think that my decisions or anybody else’s decisions on whether or not to plan to engage in family planning should be determined based on whether or not we have a worker shortage,” Subeck said. “I find that part of your testimony incredibly offensive as a woman and quite frankly as a human being.”

Kitchens said such a small group of opponents shouldn’t determine whether the bill passes.

“I respect the position of those who morally oppose birth control, but we must not allow this small group to impose their morality on others,” Kitchens said. “We should not be putting up artificial barriers that will prevent increased access to birth control, especially when there’s no medical basis to do so.”

Assembly lawmakers look at allowing pharmacists to prescribe birth control was originally published by the Wisconsin Examiner.

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Related Legislation: AB 176