On January 1, 2016, two new reproductive rights laws went into effect statewide. The first allows Oregonians to pick up a full year’s worth of birth control at a time, rather than return to the pharmacy every month. The second allows pharmacists to prescribe birth control pills and patches to patients without an appointment.
Many reproductive rights advocates had high hopes for these laws—in December 2015, Portland Monthly wrote that the new rules “make sweeping changes to how the state’s doctors and pharmacies prescribe and distribute birth control.” But more than a year later, it can be hard to tell that anything has changed at all. Here’s the deal:
Pharmacist-Prescribed Birth Control
As it turns out, this new law isn’t as simple as it may seem. As Hannah Rosenau of Oregon Foundation for Reproductive Health explains, consumers should be aware of three key details:
First and foremost, pharmacists are required to undergo voluntary training before prescribing birth control. At this point, the vast majority of pharmacists in the Portland area appear to be either unaware, unable, or uninterested in obtaining this training. “We don’t even have a public registry of who has actually been trained,” Rosenau says.
Another issue is that while pharmacists are educated about all forms of birth control, they can only prescribe the pill and the patch. If it turns out that another form of birth control (such as an IUD) might be a better fit for you, the pharmacist can refer you to a local health center.
Finally, it’s important to ask your pharmacist how much they charge for this service. The law makes it unclear whether pharmacists can bill insurance companies for the service —which is classified as an office visit and can cost nearly $50—so many pharmacists are instead charging consumers out of pocket. (In contrast, people with private insurance or Medicaid are not charged out of pocket for office visits to health centers.)
Given the law’s many limitations, it’s worth asking whether this legislation is actually helping Oregonians more easily access birth control. “If someone knows they use the pill or the patch, and they’ve called their pharmacist to see if this is an option, they can [use this new option],” Rosenau says. “But if they want to be secure that they can get in, leave the same day with any method they want, and not be charged for it, we still think a local health center or Planned Parenthood would probably be the best option.”
Although this bill is fairly straightforward, many Oregonians still report being unable to pick up a year’s supply of birth control from their pharmacy. For example, Mary Nolan, director of Planned Parenthood Advocates of Oregon, told Oregon Public Broadcasting that when she tried to pick up a prescription for her daughter in November 2016, “the pharmacist was not aware of the law, and the health insurance carrier denied the claim for extended coverage because their claims adjusters weren’t aware of the law.”
Many health care providers are also unaware of the new rules, while others are unwilling to write prescriptions that pharmacists or insurance companies may reject. This means that in order to obtain 12 months of birth control at a time, patients may need to educate their provider, their pharmacist, and their insurance company about the law.
According to OPB, Oregon’s Department of Consumer and Business Services has received so many complaints that it’s issuing a bulletin to remind insurers of their obligations. After all, failure to comply could subject insurance companies to penalties under the Oregon Insurance Code. Here’s hoping they shape up in 2017.