By Knute Buehler
Two years ago, Oregon became the first state to allow pharmacists to prescribe birth control, over-the-counter, without a prescription from a doctor. This new freedom and convenience is the result of bipartisan legislation I wrote and passed in 2015 with the goals of making birth control more widely and easily accessible, empowering women to have greater freedom and control over their health care decisions, and reducing unintended pregnancies. As a supporter of abortion rights, I was pleased that both Democrat and Republican, pro-choice and pro-life legislators came together to pass this legislation that has now served as a model for at least six other states.
Recently, The Bulletin reported and editorialized on the progress being made to implement this new law. The focus of the reporting was the progress being made to put the law into practice and the challenges it faces in achieving its full potential. For certain, the new law requires leadership and cooperation among pharmacists, retailers, insurance companies and state regulators to make it work and work well. Also, for certain, the innovative over-the-counter birth control law will need to be refined and improved as it is implemented. That will happen. The biggest hurdles, identified in the reporting, is the lack of awareness among women that this new convenience and freedom even exists, the need to ensure proper training of pharmacists and the billing and reimbursement logistics that are needed among insurance companies, the Oregon Health Plan and coordinated care organizations.
Dr. Maria Rodriguez, an assistant professor of obstetrics and gynecology at Oregon Health & Science University (OHSU), summarized the situation really well: “Implementation of any kind of policy is always a much slower process than most people realize. Just because a policy is on the books doesn’t mean it’s fully enacted. I think things in Oregon have really been a case example for the nation in terms of the smoothness and how well it’s been implemented.”
While challenges exist, and regulatory and legislative changes should always be considered, it’s important to note OHSU will soon publish research showing that as of last fall, 1,300 of the estimated 1,600 retail pharmacists in Oregon have been certified, and that 68 percent of Oregon ZIP codes have at least one pharmacist who has completed the training. That’s a positive start in expanding accessibility.
However, I also agree that an important improvement to the law would be for private and public insurers to adopt protocols to speed up payments to pharmacists for the crucial role they play in advising customers and distributing birth control. If insurers don’t adapt quickly enough, they should be prepared for lawmakers to step in. I’d prefer to see this process happen more quickly and through cooperation, rather than a new law.
When I introduced this idea in 2015, I was told by many Capitol insiders that passing over-the-counter birth control would be impossible. Some said divisive abortion politics would derail the idea. Others said a Republican in the minority during his first year in office lacked the clout or experience to pass such an innovative law. At times, I will confess, I thought the naysayers might be right. But what I learned in 2015 was the power of a good idea. A common sense idea. An idea that looked beyond the narrow labels that too often define politics today and that could unite people across partisan divides. Oregon has this new law because it is smart policy and good for consumers, particularly women, who no longer need permission from their doctor to purchase birth control. I urge Oregonians to take advantage of it.