Access to Birth Control Act
This bill requires pharmacies to comply with certain rules related to ensuring access to contraceptives.
Specifically, pharmacies must provide without delay a customer with any contraceptive or related medication that is in stock. If the contraceptive is not in stock, the pharmacy must immediately inform the customer and either order the contraceptive or refer the customer to a pharmacy that has it in stock. Laws in some states provide pharmacists with the right to refuse to dispense contraceptive-related drugs on religious or conscience grounds.
Pharmacies may refuse to provide a contraceptive to a customer (1) if the customer lacks a valid prescription for a prescription contraceptive or is unable to pay for the contraceptive, or (2) based on a pharmacy employee's professional clinical judgment.
The bill also establishes a private cause of action and civil monetary penalties for violations of the bill.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6005 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 6005
To establish certain duties for pharmacies to ensure provision of Food
and Drug Administration-approved contraception, medication related to
contraception, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 17, 2021
Mrs. Carolyn B. Maloney of New York (for herself, Ms. Porter, Ms. Kelly
of Illinois, Mrs. Hayes, Ms. Speier, Ms. Brownley, Ms. Bonamici, Mr.
Cooper, Ms. Norton, Mr. Welch, Mr. Connolly, Mr. Auchincloss, Ms.
Jacobs of California, Ms. Schakowsky, Mr. Sires, Ms. Lois Frankel of
Florida, Ms. Underwood, Ms. Williams of Georgia, Mr. DeFazio, Ms.
Newman, Mrs. Lawrence, Mr. Grijalva, Ms. Pingree, Ms. Lee of
California, Ms. Strickland, Mr. Danny K. Davis of Illinois, Mr.
Blumenauer, Mr. Lowenthal, Mr. Espaillat, Mrs. Kirkpatrick, Ms. Titus,
Ms. Jackson Lee, Ms. DeGette, Ms. Escobar, Mr. Takano, Mrs. McBath,
Mrs. Watson Coleman, Mr. Larson of Connecticut, Ms. Castor of Florida,
Mr. Gomez, Mr. Smith of Washington, Ms. Pressley, Mrs. Fletcher, Ms.
Meng, Mrs. Napolitano, Mr. Pappas, Ms. Moore of Wisconsin, Ms. Sewell,
Mr. Torres of New York, Mr. Deutch, Ms. Manning, Ms. Adams, Mrs.
Trahan, Ms. Clarke of New York, Ms. Wilson of Florida, Ms. Omar, Mr.
Huffman, Mr. Gallego, Mr. Morelle, Ms. Velazquez, Mr. DeSaulnier, Ms.
Ross, Ms. Scanlon, Mr. Doggett, Mr. Raskin, Mr. Kahele, Ms. Schrier,
Mr. Crow, Mr. Lieu, Ms. Johnson of Texas, Ms. Chu, Mr. Bowman, Ms.
Leger Fernandez, Ms. DeLauro, Mr. Cicilline, Mr. Payne, Mr. Soto, Mr.
Garcia of Illinois, Mr. Brown of Maryland, Mr. Trone, Ms. Tlaib, Ms.
Kuster, Mr. Carson, Mr. McNerney, Mr. Nadler, Ms. Bass, Mr. Veasey, Ms.
Dean, Mr. Neguse, Mr. Khanna, Ms. Garcia of Texas, Mr. Lawson of
Florida, Mr. Cohen, Mr. Sarbanes, Ms. Matsui, Mr. Johnson of Georgia,
Mr. Green of Texas, Ms. McCollum, and Mr. Perlmutter) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To establish certain duties for pharmacies to ensure provision of Food
and Drug Administration-approved contraception, medication related to
contraception, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Access to Birth Control Act''.
SEC. 2. FINDINGS.
Congress finds as follows:
(1) Family planning is basic health care. Access to
contraception helps prevent unintended pregnancy and control
the timing and spacing of planned births.
(2) As a result of the enactment of the Patient Protection
and Affordable Care Act (Public Law 111-148), approximately
64,300,000 women had coverage of the full range of Food and
Drug Administration-approved contraceptive methods without cost
sharing in 2020.
(3) The Patient Protection and Affordable Care Act saved
women $1,400,000,000 on birth control pills alone in 2013.
(4) According to the Centers for Disease Control and
Prevention, nearly \2/3\ of women between the ages of 15 and 49
are currently using a contraceptive method.
(5) Although the Centers for Disease Control and Prevention
included family planning in its published list of the Ten Great
Public Health Achievements in the 20th Century, the United
States still has one of the highest rates of unintended
pregnancies among industrialized nations.
(6) Each year, approximately 2,800,000 pregnancies, nearly
half of all pregnancies, in the United States are unintended.
(7) Access to birth control helps people achieve their
goals of whether, and when, to get pregnant. Studies show that
when people are unable to access contraceptive care that fits
their lives, they are more likely to face unintended
pregnancies.
(8) Contraceptives are used for a range of medical purposes
in addition to preventing pregnancy, such as treating abnormal
cycles and endometriosis.
(9) The Food and Drug Administration has approved multiple
emergency contraceptive methods as safe and effective in
preventing unintended pregnancy and has approved over-the-
counter access to some forms of emergency contraception for all
individuals, regardless of age. If taken soon after unprotected
sex or primary contraceptive failure, emergency contraception
can significantly reduce a person's chance of unintended
pregnancy.
(10) Legal contraception is a protected fundamental right
in the United States and should not be impeded by one
individual's personal beliefs.
(11) Reports of pharmacists refusing to fill prescriptions
for contraceptives, including emergency contraceptives, or
provide emergency contraception over-the-counter have surfaced
in States across the Nation, including Alabama, Arizona,
California, the District of Columbia, Georgia, Illinois,
Louisiana, Massachusetts, Michigan, Minnesota, Missouri,
Montana, New Hampshire, New Mexico, New York, North Carolina,
Ohio, Oklahoma, Oregon, Rhode Island, Tennessee, Texas,
Washington, West Virginia, and Wisconsin.
(12) One-third of women have experienced a delay in
accessing their contraception because of the ongoing
coronavirus pandemic. The Centers for Disease Control and
Prevention recognizes the importance of access to
contraception, particularly during the pandemic.
(13) Pregnant people have a much higher risk of dying once
infected with COVID-19, which highlights the importance of
people being able to make and exercise decisions about whether
and when to become pregnant.
SEC. 3. DUTIES OF PHARMACIES TO ENSURE PROVISION OF FDA-APPROVED
CONTRACEPTION AND MEDICATION RELATED TO CONTRACEPTION.
Part B of title II of the Public Health Service Act (42 U.S.C. 238
et seq.) is amended by adding at the end the following:
``SEC. 249. DUTIES OF PHARMACIES TO ENSURE PROVISION OF FDA-APPROVED
CONTRACEPTION AND MEDICATION RELATED TO CONTRACEPTION.
``(a) In General.--Subject to subsection (c), a pharmacy that
receives Food and Drug Administration-approved drugs or devices in
interstate commerce shall maintain compliance with the following:
``(1) If a customer requests a contraceptive or a
medication related to a contraceptive that is in stock, the
pharmacy shall ensure that the contraceptive or the medication
related to a contraceptive is provided to the customer without
delay.
``(2) If a customer requests a contraceptive or a
medication related to a contraceptive that is not in stock and
the pharmacy in the normal course of business stocks
contraception or the medication related to contraception, the
pharmacy shall immediately inform the customer that the
contraceptive or the medication related to a contraceptive is
not in stock and without delay offer the customer the following
options:
``(A) If the customer prefers to obtain the
contraceptive or the medication related to a
contraceptive through a referral or transfer, the
pharmacy shall--
``(i) locate a pharmacy of the customer's
choice or the closest pharmacy confirmed to
have the contraceptive or the medication
related to a contraceptive in stock; and
``(ii) refer the customer or transfer the
prescription to that pharmacy.
``(B) If the customer prefers for the pharmacy to
order the contraceptive or the medication related to a
contraceptive, the pharmacy shall obtain the
contraceptive or the medication related to a
contraceptive under the pharmacy's standard procedure
for expedited ordering of medication and notify the
customer when the contraceptive or the medication
related to a contraceptive arrives.
``(3) The pharmacy shall ensure that--
``(A) it does not operate an environment in which
customers are intimidated, threatened, or harassed in
the delivery of services relating to a request for
contraception or a medication related to contraception;
``(B) its employees do not interfere with or
obstruct the delivery of services relating to a request
for contraception or a medication related to
contraception;
``(C) its employees do not intentionally
misrepresent or deceive customers about the
availability of contraception or a medication related
to contraception or its mechanism of action;
``(D) its employees do not breach medical
confidentiality with respect to a request for a
contraception or a medication related to contraception
or threaten to breach such confidentiality; or
``(E) its employees do not refuse to return a
valid, lawful prescription for a contraception or a
medication related to contraception upon customer
request.
``(b) Contraceptives or Medication Related to a Contraceptive Not
Ordinarily Stocked.--Nothing in subsection (a)(2) shall be construed to
require any pharmacy to comply with such subsection if the pharmacy
does not ordinarily stock contraceptives or medication related to a
contraceptive in the normal course of business.
``(c) Refusals Pursuant to Standard Pharmacy Practice.--This
section does not prohibit a pharmacy from refusing to provide a
contraceptive or a medication related to a contraceptive to a customer
in accordance with any of the following:
``(1) If it is unlawful to dispense the contraceptive or
the medication related to a contraceptive to the customer
without a valid, lawful prescription and no such prescription
is presented.
``(2) If the customer is unable to pay for the
contraceptive or the medication related to a contraceptive.
``(3) If the employee of the pharmacy refuses to provide
the contraceptive or the medication related to a contraceptive
on the basis of a professional clinical judgment.
``(d) Relation to Other Laws.--
``(1) Rule of construction.--Nothing in this section shall
be construed to invalidate or limit rights, remedies,
procedures, or legal standards under title VII of the Civil
Rights Act of 1964.
``(2) Certain claims.--The Religious Freedom Restoration
Act of 1993 (42 U.S.C. 2000bb et seq.) shall not provide a
claim concerning, or a defense to a claim under, a covered
title, or provide a basis for challenging the application or
enforcement of a covered title.
``(e) Preemption.--This section does not preempt any provision of
State law or any professional obligation made applicable by a State
board or other entity responsible for licensing or discipline of
pharmacies or pharmacists, to the extent that such State law or
professional obligation provides protections for customers that are
greater than the protections provided by this section.
``(f) Enforcement.--
``(1) Civil penalty.--A pharmacy that violates a
requirement of subsection (a) is liable to the United States
for a civil penalty in an amount not exceeding $1,000 per day
of violation, not to exceed $100,000 for all violations
adjudicated in a single proceeding.
``(2) Private cause of action.--Any person aggrieved as a
result of a violation of a requirement of subsection (a) may,
in any court of competent jurisdiction, commence a civil action
against the pharmacy involved to obtain appropriate relief,
including actual and punitive damages, injunctive relief, and a
reasonable attorney's fee and cost.
``(3) Limitations.--A civil action under paragraph (1) or
(2) may not be commenced against a pharmacy after the
expiration of the 5-year period beginning on the date on which
the pharmacy allegedly engaged in the violation involved.
``(g) Definitions.--In this section:
``(1) The term `contraception' or `contraceptive' means any
drug or device approved by the Food and Drug Administration to
prevent pregnancy.
``(2) The term `employee' means a person hired, by contract
or any other form of an agreement, by a pharmacy.
``(3) The term `medication related to contraception' or
`medication related to a contraceptive' means any drug or
device approved by the Food and Drug Administration that a
medical professional determines necessary to use before or in
conjunction with contraception or a contraceptive.
``(4) The term `pharmacy' means an entity that--
``(A) is authorized by a State to engage in the
business of selling prescription drugs at retail; and
``(B) employs one or more employees.
``(5) The term `product' means a Food and Drug
Administration-approved drug or device.
``(6) The term `professional clinical judgment' means the
use of professional knowledge and skills to form a clinical
judgment, in accordance with prevailing medical standards.
``(7) The term `without delay', with respect to a pharmacy
providing, providing a referral for, or ordering contraception
or a medication related to contraception, or transferring the
prescription for contraception or a medication related to
contraception, means within the usual and customary timeframe
at the pharmacy for providing, providing a referral for, or
ordering other products, or transferring the prescription for
other products, respectively.
``(h) Effective Date.--This section shall take effect on the 31st
day after the date of the enactment of this section, without regard to
whether the Secretary has issued any guidance or final rule regarding
this section.''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
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